الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 213 |  |  |
| | | from | 213 | | |
Abstract
The aim of this work was to do functional assessment of the outer retinal layers in RRMS patients (during remission) by full-field electroretinogram (ff-ERG) and multifocal electroretinogram (mf-ERG) and to correlate the findings with the structural assessment of retina done by spectral-domain optical coherence tomography (OCT).
Methodology:
This is a case- control study, conducted on 30 RRMS patients in addition to 30 age and sex matched healthy control.
All patients were subjected to thorough history taking focusing on disease duration, total number of relapses, history of optic neuritis and the prescribed disease modifying drugs (DMDs).
All MS patients were subjected to neurological assessment (EDSS and MFIS) radiological assessment (MRI) and ophthalmological assessment.
All MS patients and controls were subjected to full field ERG, multifocal ERG and OCT
Results:
The study included 41 (69.3%) females and 19 (31.7%) males without a statistically significant difference between cases and controls. The mean disease duration was 78.57 ±66.76. The mean value for the total relapse number was 5.70 ±5.40. The mean value for Expanded disability scale (EDSS) among studied MS patients was (3.033 ±1.53) points. The mean value for Modified Fatigue impact scale (MFIS) was (31.20 ±14.57) points. The mean value for MRI lesion load was (10.53 ±4.66) points. About 23 (38.3%) of the studied MS eyes have a history of optic neuritis.
Regarding ff-ERG, there was statistically significant prolonged latencies and reduced amplitudes of all a and b waves of the dark-adapted (combined rod-cone responses and oscillatory potentials) and the light adapted responses (cone and flicker) responses in MS patients compared to control. There was statistically significant delay in the latency of b-wave the dark-adapted rod response without statistically significant difference in their amplitudes. There was no statistically significant difference in b-wave /a-wave amplitude ratio between patient and control. Almost all the results showed no statistically significant differences between MS optic neuritis - eyes as compared with MS- non-optic neuritis eyes except for the amplitude of b-wave of combined rod and cone response. which showed significant differences in MS optic neuritis eyes.
Regarding mf-ERG, there was statistically significant prolongation in the P1 peak time of all five retinal rings with a statistically significant reduction of their amplitudes. Almost all the results showed no statistically significant differences between MS optic neuritis - eyes as compared with MS- non-optic neuritis eyes except for the ring 2 peak time and ring 3 amplitude which showed significant differences in MS optic neuritis eyes.
Regarding OCT, outer and inner retinal thickness of fovea, parafovea and perifovea showed a statistically significant difference in comparison to control. There were no statistically significant differences between MS- optic neurites eyes and MS -non-ON eyes.
Regarding clinical and radiological correlation, Disease duration showed a statistically significant correlation with 1-amplitude of b- wave of the dark adapted 3.0 combined rod and cone responses of ff-ERG. 2- the amplitude of a-wave in light adapted response of ff-ERG. 3-Ring1 and 2 amplitudes of mf-ERG.4-Ring 4 peak time of mf-ERG. Total relapse number showed a statistically significant correlation with ring 1 and 3 amplitudes of mf-ERG. 2- ring 4 and 5 peak times of mf-ERG. Expanded Disability Status Scale (EDSS) showed a statistically significant correlation with ring 3 ,4 and 5 peak times. MRI lesion load showed a statistically significant correlation with 1-Ring 3 and 4 peak times of mf-ERG 2- parafovea of outer retinal thickness of OCT. EDSS showed a statistically significant correlation with parafovea of outer retinal thickness of OCT.
The ff-ERG responses (b-waves of rod, b-wave of combined rod cone responses, a -wave of cone response and oscillatory potentials) showed statistically significant correlation with the thickness of the outer retinal layer of OCT among MS patients. In addition, ff-ERG (b- wave of rod, b-wave of cone response, a and b-waves of combined rod cone response and flicker response of ff-ERG) showed statistically significant correlation with thickness of the inner retinal layer of OCT
There was a statistically significant correlation between the central ring 1 amplitude of the mf-ERG with the foveal thickness of the outer retinal layers thickness of OCT among studied MS eyes.
There was a statistically significant correlation between the thickness of the inner retinal layer of OCT with mf-ERG rings among studied MS eyes., however the central ring 1 amplitude showed no statistically significant correlation with the foveal thickness of the inner retinal layer.