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Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test

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Pihl-Jensen, Gorm ; Ivanov, Iliya ; Hinze, Desiree ; Trauzettel-Klosinski, Susanne ; Frederiksen, Jette Lautrup. / Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test. In: Ophthalmic Research. 2020 ; Vol. 63, No. 3. pp. 332-340.

Bibtex

@article{e704af13eb7f41dea67fc6b9fb7635a5,
title = "Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test",
abstract = "BACKGROUND: The Aulhorn flicker test (AFT) previously showed promise in diagnosing acute optic neuritis (ON) albeit with suboptimal sensitivity. A new, digitalized version of the AFT (the DFT) has not previously been examined in acute ON.OBJECTIVES: To examine the sensitivity, specificity and reproducibility of the DFT in acute ON.METHOD: The DFT assesses the subjective brightness of a flickering field (1-60 Hz). In normal subjects, brightness enhancement occurs at intermediate frequencies, whereas in acute ON darkness enhancement (DE) is hypothesized. AFT and DFT measurements were obtained in acute ON patients (≤31 days from first symptom) with DE as a quantitative covariate. Reproducibility of the DFT end point was assessed in the form of an intraclass correlation.RESULTS: 30 untreated first-time acute ON patients and 55 healthy controls were examined. AFT and DFT were performed 12.7 days (range: 4-30) following ON onset. The DFT showed a sensitivity of 0.93 (95{\%} CI = 0.78-0.99) to a specificity of 0.96 (95{\%} CI = 0.87-1.00). The AFT showed a sensitivity of 0.76 (95{\%} CI = 0.56-0.90) to a specificity of 1.00 (95{\%} CI = 0.93-1.00). No significant correlation was shown between DFT and visual acuity. The intraclass correlation of the DFT end point in healthy subjects was 0.84.CONCLUSIONS: We present a new DFT in acute ON displaying a high specificity of 0.96 and a sensitivity of 0.93. Our study indicates the DFT to be an accurate and easy-to-use tool in diagnosing acute ON, which may be especially helpful in atypical cases.",
keywords = "Demyelinating diseases, Diagnostic test, Flicker test, Optic neuritis, Optic neuropathy",
author = "Gorm Pihl-Jensen and Iliya Ivanov and Desiree Hinze and Susanne Trauzettel-Klosinski and Frederiksen, {Jette Lautrup}",
note = "{\circledC} 2019 S. Karger AG, Basel.",
year = "2020",
doi = "10.1159/000503304",
language = "English",
volume = "63",
pages = "332--340",
journal = "Ophthalmic Research",
issn = "0030-3747",
publisher = "S./Karger AG",
number = "3",

}

RIS

TY - JOUR

T1 - Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test

AU - Pihl-Jensen, Gorm

AU - Ivanov, Iliya

AU - Hinze, Desiree

AU - Trauzettel-Klosinski, Susanne

AU - Frederiksen, Jette Lautrup

N1 - © 2019 S. Karger AG, Basel.

PY - 2020

Y1 - 2020

N2 - BACKGROUND: The Aulhorn flicker test (AFT) previously showed promise in diagnosing acute optic neuritis (ON) albeit with suboptimal sensitivity. A new, digitalized version of the AFT (the DFT) has not previously been examined in acute ON.OBJECTIVES: To examine the sensitivity, specificity and reproducibility of the DFT in acute ON.METHOD: The DFT assesses the subjective brightness of a flickering field (1-60 Hz). In normal subjects, brightness enhancement occurs at intermediate frequencies, whereas in acute ON darkness enhancement (DE) is hypothesized. AFT and DFT measurements were obtained in acute ON patients (≤31 days from first symptom) with DE as a quantitative covariate. Reproducibility of the DFT end point was assessed in the form of an intraclass correlation.RESULTS: 30 untreated first-time acute ON patients and 55 healthy controls were examined. AFT and DFT were performed 12.7 days (range: 4-30) following ON onset. The DFT showed a sensitivity of 0.93 (95% CI = 0.78-0.99) to a specificity of 0.96 (95% CI = 0.87-1.00). The AFT showed a sensitivity of 0.76 (95% CI = 0.56-0.90) to a specificity of 1.00 (95% CI = 0.93-1.00). No significant correlation was shown between DFT and visual acuity. The intraclass correlation of the DFT end point in healthy subjects was 0.84.CONCLUSIONS: We present a new DFT in acute ON displaying a high specificity of 0.96 and a sensitivity of 0.93. Our study indicates the DFT to be an accurate and easy-to-use tool in diagnosing acute ON, which may be especially helpful in atypical cases.

AB - BACKGROUND: The Aulhorn flicker test (AFT) previously showed promise in diagnosing acute optic neuritis (ON) albeit with suboptimal sensitivity. A new, digitalized version of the AFT (the DFT) has not previously been examined in acute ON.OBJECTIVES: To examine the sensitivity, specificity and reproducibility of the DFT in acute ON.METHOD: The DFT assesses the subjective brightness of a flickering field (1-60 Hz). In normal subjects, brightness enhancement occurs at intermediate frequencies, whereas in acute ON darkness enhancement (DE) is hypothesized. AFT and DFT measurements were obtained in acute ON patients (≤31 days from first symptom) with DE as a quantitative covariate. Reproducibility of the DFT end point was assessed in the form of an intraclass correlation.RESULTS: 30 untreated first-time acute ON patients and 55 healthy controls were examined. AFT and DFT were performed 12.7 days (range: 4-30) following ON onset. The DFT showed a sensitivity of 0.93 (95% CI = 0.78-0.99) to a specificity of 0.96 (95% CI = 0.87-1.00). The AFT showed a sensitivity of 0.76 (95% CI = 0.56-0.90) to a specificity of 1.00 (95% CI = 0.93-1.00). No significant correlation was shown between DFT and visual acuity. The intraclass correlation of the DFT end point in healthy subjects was 0.84.CONCLUSIONS: We present a new DFT in acute ON displaying a high specificity of 0.96 and a sensitivity of 0.93. Our study indicates the DFT to be an accurate and easy-to-use tool in diagnosing acute ON, which may be especially helpful in atypical cases.

KW - Demyelinating diseases

KW - Diagnostic test

KW - Flicker test

KW - Optic neuritis

KW - Optic neuropathy

U2 - 10.1159/000503304

DO - 10.1159/000503304

M3 - Journal article

VL - 63

SP - 332

EP - 340

JO - Ophthalmic Research

JF - Ophthalmic Research

SN - 0030-3747

IS - 3

ER -

ID: 58956519