Neuro-Ophthalmology Poster Presentation

P0764 - A prognostically relevant functional-structural relationship in acute optic neuritis (ID 1569)

  • I. Kleerekooper
  • I. Kleerekooper
  • S. Leo
  • I. Davagnanam
  • L. Del Porto
  • J. Guajardo
  • L. Dell'Arti
  • A. Robson
  • S. Trip
  • G. Holder
  • G. Plant
  • A. Petzold
Presentation Number
Presentation Topic



In the setting of acute optic neuritis (ON) it can be difficult to accurately predict clinical recovery and differentiate between the various associated syndromes.


To prospectively investigate if comprehensive electrodiagnostic testing in acute optic neuritis (ON) can predict functional recovery or identify differences between ON subtypes.


Patients presenting with acute typical demyelinating ON and controls underwent pattern visual evoked potentials (PVEP), pattern electroretinography (PERG) and optical coherence tomography (OCT) within 14 days of symptom onset. OCT and visual acuity evaluation were repeated after approximately 3 months.


We recruited 25 ON patients (11 isolated ON, 9 multiple sclerosis associated ON and 6 myelin-oligodendrocyte glycoprotein (MOG) seropositive ON) and 5 controls. All subjects were included acutely, with investigations done on average 6.7 days from first symptoms. Nine patients had conduction block at baseline. PVEP peak times were increased and amplitudes were decreased in ON. The PERGs showed that N95 and P50 amplitudes as well as P50 peak times were decreased in ON. None of the PVEP and PERG measures differed across the ON subtypes. A PVEP amplitude reduction was related to more severe GCL loss and thinner pRNFL layer at follow up (r=-0.58; p=0.008 and r=0.72; p=0.021). No such correlation existed at baseline. PVEP peak times and PERG measures were not similarly prognostic for structural outcome.


These data suggest that in acute ON, reduced neuronal function, as indirectly assessed by the reduced PVEP amplitudes, is predictive of subsequent neuronal loss. PVEP amplitudes may be helpful in guiding treatment decisions in acute ON.