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| Application of VEP OCT and MfVEP in the Diagnosis and Disease Outcomes of Pediatric Optic Neuritis |
| HUA Huilan, ZHAO Jingcong, TIAN Haixia, et al |
| Hebei Children's Hospital, Hebei Shijiazhuang 050031, China |
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Abstract Objective: To analyze clinical characteristics of PON with different causes and to explore the value of VEP, OCT and mfVEP in the diagnosis of PON and its significance in clinical outcomes. Methods: Sixty children in the neurology ward and ophthalmology ward of Hebei Children's Hospital who were confirmed by professional physicians to be eligible for the diagnosis of optic neuritis were collected and divided into 28 cases in the isolated optic neuritis group (ON group), 11 cases in the multiple sclerosis group (MS group), 14 cases in the acute disseminated encephalomyelitis group (ADEM group) and 7 cases in the optic neuromyelitis optica spectrum disorder group (NMOSD group) according to different etiologies, and 30 children for physical examination in the same period were selected as the healthy controls. The children with PON in different groups were observed for differences in imaging, serology and eye examination. VEP, OCT and mfVEP were also performed at the first visit, at half a month, one month, three months, six months and one year to observe the changes in the disease and its outcome.Results: When comparing the MS and NMOSD groups, ON children were prone to monocular onset and ADEM children were prone to binocular onset (P<0.05); In the acute phase of the disease, vision was less affected in the ON group and in the MS group, and greatly in the ADEM and NMOSD groups (P<0.001); compared to the MS and ADEM groups, children in the ON group were more sensitive to hormones, while the NMOSD group was insensitive or less effective (P<0.05); VEP examination is meaningful for the differential diagnosis of MS, and can reflect the effect of treatment to some extent; OCT examination can visually reflectthe significant thinning of the pRNFL in the NMOSD group, which can be used as a differential diagnosis of NMOSD and can be used to assess the disease progression of NMOSD and develop the corresponding treatment regimen. The mfVEP test is better than the conventional VEP and visual field tests in detecting damage to the optic nerve and tracking recovery.Conclusion: VEP, OCT and mfVEP tests can more intuitively reflect the characteristics of children with different causes of PON, which deserves further clinical promotion.
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2022, Vol. 28 
