Which is more sensitive in multiple sclerosis: Optical coherence tomography or visual evoked potentials?

Objectives Visual involvement is a frequent feature of multiple sclerosis (MS). Visual disturbances involve up to 80% of patients and optic neuritis (ON) occurs in about 50%. Our aim was to assess the sensitivity of optic coherence tomography (OCT) and visual evoked potentials (VEPs) to visual pathway abnormalities in MS. Methods A total of 19 MS subjects, 9 with optic neuritis (ON) at least 3 months before (bilateral in 6), underwent assessment of optical coherence tomography (OCT) and VEPs. Results There were 19 patients with MS, so a total of 38 eyes. The sex ratio was 0.73 F/M. The average age was 37.7 years old. There were 15 eyes with history of ON. Global retinal nerve fibre layer (RNFL) thickness in OCT was abnormal in 57.9% of all eyes and the VEPs were abnormal in 68.42%. The eyes with NO had an abnormal VEPs in 73.33% and a decreased pRNFL in 66.66%. A total of 60.86% of eyes without NO had abnormal VEPs and 47.82% had decreased pRNFL ( P  = 0.008). Conclusion In eyes with or without ON, VEPs were more frequently abnormal than OCT, while the difference insensitivity of the two techniques was higher in eyes not affected previously by ON.