Optic Nerve Involvement and Diagnosing Multiple Sclerosis

The 2017 McDonald criteria for multiple sclerosis (MS) diagnosis do not include the optic nerve as a site for dissemination in space (DIS). Investigators evaluated performance characteristics of the optic nerve as a fifth region in a clinically isolated syndrome (CIS) cohort. Of 1238 participants, 388 patients <50 years old with CIS were included, 151 of whom had a second clinical event or at least 10 years follow-up. The researchers collected data on brain and spine MRI and on visual evoked potentials (VEPs). VEPs were considered abnormal based on local normative data: P100 wave latency >112 milliseconds, >8 milliseconds inter-eye latency, or absence of P100 wave. MS was confirmed by a second clinical attack.

Among all 1238 patients, VEPs w…