Diagnostic ability of multifocal electroretinogram in early multiple sclerosis using a new signal analysis method

PLoS One. 2019 Nov 8;14(11):e0224500. doi: 10.1371/journal.pone.0224500. eCollection 2019.

Abstract

Purpose: To determine if a novel analysis method will increase the diagnostic value of the multifocal electroretinogram (mfERG) in diagnosing early-stage multiple sclerosis (MS).

Methods: We studied the mfERG signals of OD (Oculus Dexter) eyes of fifteen patients diagnosed with early-stage MS (in all cases < 12 months) and without a history of optic neuritis (ON) (F:M = 11:4), and those of six controls (F:M = 3:3). We obtained values of amplitude and latency of N1 and P1 waves, and a method to assess normalized root-mean-square error (FNRMSE) between model signals and mfERG recordings was used. Responses of each eye were analysed at a global level, and by rings, quadrants and hemispheres. AUC (area under the ROC curve) is used as discriminant factor.

Results: The standard method of analysis obtains further discrimination between controls and MS in ring R3 (AUC = 0.82), analysing N1 waves amplitudes. In all of the retina analysis regions, FNRMSE value shows a greater discriminating power than the standard method. The highest AUC value (AUC = 0.91) was in the superior temporal quadrant.

Conclusion: By analysing mfERG recordings and contrasting them with those of healthy controls it is possible to detect early-stage MS in patients without a previous history of ON.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Area Under Curve
  • Electroretinography*
  • Female
  • Humans
  • Male
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / physiopathology
  • ROC Curve
  • Signal Processing, Computer-Assisted*
  • Visual Fields / physiology

Grants and funding

This work was supported by the Carlos III Health Institute [grant number PI17/01726, “Neuro-ophthalmological evaluation as a biomarker of diagnosis, monitoring and prognosis in multiple sclerosis”, to EGM]; Secretary of State for Research, Development and Innovation [grant number DPI2017-88438-R (AEI/FEDER, UE) to LB] and RETICS Oftared, RD16/0008/020 to LB and RD16/0008/029 to EGM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.