Optic Neuritis Patients Research Articles

Assessment of visual disability using visual evoked potentials

BackgroundThe purpose of this study is to validate the use of visual evoked potential (VEP) to objectively quantify visual acuity in normal and amblyopic patients, and determine if it is possible to predict visual acuity in disability assessment to register visual pathway lesions.MethodsA retrospective chart review was conducted of patients diagnosed with normal vision, unilateral amblyopia, optic neuritis, and visual disability who visited the university medical center for registration from March 2007 to October 2009. The study included 20 normal subjects (20 right eyes: 10 females, 10 males, ages 9–42 years), 18 unilateral amblyopic patients (18 amblyopic eyes, ages 19–36 years), 19 optic neuritis patients (19 eyes: ages 9–71 years), and 10 patients with visual disability having visual pathway lesions. Amplitude and latencies were analyzed and correlations with visual acuity (logMAR) were derived from 20 normal and 18 amblyopic subjects. Correlation of VEP amplitude and visual acuity (logMAR) of 19 optic neuritis patients confirmed relationships between visual acuity and amplitude. We calculated the objective visual acuity (logMAR) of 16 eyes from 10 patients to diagnose the presence or absence of visual disability using relations derived from 20 normal and 18 amblyopic eyes.ResultsLinear regression analyses between amplitude of pattern visual evoked potentials and visual acuity (logMAR) of 38 eyes from normal (right eyes) and amblyopic (amblyopic eyes) subjects were significant [y = −0.072x + 1.22, x: VEP amplitude, y: visual acuity (logMAR)]. There were no significant differences between visual acuity prediction values, which substituted amplitude values of 19 eyes with optic neuritis into function. We calculated the objective visual acuity of 16 eyes of 10 patients to diagnose the presence or absence of visual disability using relations of y = −0.072x + 1.22 (−0.072). This resulted in a prediction reference of visual acuity associated with malingering vs. real disability in a range >5.77 μV. The results could be useful, especially in cases of no obvious pale disc with trauma.ConclusionsVisual acuity quantification using absolute value of amplitude in pattern visual evoked potentials was useful in confirming subjective visual acuity for cutoff values >5.77 μV in disability evaluation to discriminate the malingering from real disability.

A 28-channel coil array for improved imaging of the optic nerve

This work describes the design and construction of a radio-frequency (RF) coil optimized for imaging the optic nerve on a Siemens 3T TIM Trio MRI scanner. The specific goals were to optimize signal sensitivity from the orbit to the optic chiasm and improve SNR over previous designs. The optic nerve (ON) coil was constructed using two fiberglass formers that fit together in a clamshell arrangement to maintain a high filling factor for any head size. This design maintains close coil-to-sample coupling near the eyes and around the entire head to eliminate the air void regions that occur between coil and sample when heads are imaged in one-piece rigid head coils. The anterior mask former holds 26 overlapping coil elements in a soccer ball layout. The posterior former supports the neck and head and houses two additional overlapped coil elements, totaling to 28 elements. Signal-to-noise-ratio (SNR) measurements on a custom-made homogeneous head phantom using the optic nerve coil showed a 310% increase in SNR near the orbits and 60% increase at the optic chiasm compared to the 12-channel Siemens head coil. Inverse g-factor maps show that the ON coil performs well for parallel imaging over the region of the optic nerve, providing a possible reduction of eyeball motion artifacts. Images from volunteer studies demonstrate that high-resolution imaging of the optic nerve can be achieved using 3T MRI with advanced imaging coils, leading to improved patient care for optic neuritis patients. © 2012 Wiley Periodicals, Inc. Concepts Magn Reson Part B (Magn Reson Engineering) 41B: 73–84, 2012

Augenärztliche Aspekte Multipler Sklerose im Kindes- und Jugendalter

Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system of unknown aetiology. The onset of MS in childhood poses diagnostic and therapeutic challenges. Differential diagnoses include acute disseminated encephalomyelitis and neurometabolic leukoencephalopathies. In this article the ophthalmological findings of paediatric and adolescent MS patients are described and discussed in the light of earlier studies. In a retrospective study we evaluated the ophthalmological and neuro-ophthalmological findings of 44 paediatric/adolescent MS patients (aged 8-18 years). In 18/44 patients optic neuritis was found. Abnormalities of ocular motility were seen in 9/44 patients, 5/44 had abduction limitation, 3/44 internuclear ophthalmoplegia and 1/44 horizontal gaze palsy. Furthermore, 13/44 children showed nystagmus, mostly gaze-induced nystagmus. Uveitis was present in 4/44 patients. The ophthalmological and neuroophthalmological findings may lead to the diagnosis of MS. Children presenting with these symptoms should be examined by a paediatric neurologist.

Efficacy of vision restoration therapy after optic neuritis (VISION study): study protocol for a randomized controlled trial

BackgroundOptic neuritis is a frequent manifestation of multiple sclerosis. Visual deficits range from a minor impairment of visual functions through to complete loss of vision. Although many patients recover almost completely, roughly 35% of patients remain visually impaired for years, and therapeutic options for those patients hardly exist. Vision restoration therapy is a software-based visual training program that has been shown to improve visual deficits after pre- and postchiasmatic injury. The aim of this pilot study is to evaluate whether residual visual deficits after past or recent optic neuritis can be reduced by means of vision restoration therapy.Methods/designA randomized, controlled, patient- and observer-blinded clinical pilot study (VISION study) was designed to evaluate the efficacy of vision restoration therapy in optic neuritis patients. Eighty patients with a residual visual deficit after optic neuritis (visual acuity ≤0.7 and/or scotoma) will be stratified according to the time of optic neuritis onset (manifestation more than 12 months ago (40 patients, fixed deficit) versus manifestation 2 to 6 months ago (40 patients, recent optic neuritis)), and randomized into vision restoration therapy arm or saccadic training arm (control intervention). Patients will be instructed to complete a computer-based visual training for approximately 30 minutes each day for a period of 6 months. Patients and evaluators remain blinded to the treatment allocation throughout the study. All endpoints will be analyzed and P-values < 0.05 will be considered statistically significant. The primary outcome parameter will be the expansion of the visual field after 3 and 6 months of treatment as determined by static visual field perimetry and high resolution perimetry. Secondary outcome variables will include visual acuity at both low and high contrast, glare contrast sensitivity, visually evoked potentials, optical coherence tomography and other functional tests of the visual system, alertness, health-related quality of life, fatigue, and depression.DiscussionIf vision restoration therapy is shown to improve visual function after optic neuritis, this method might be a first therapeutic option for patients with incomplete recovery from optic neuritis.Trial registrationNCT01274702

Clinical analysis of the etiology of optic neuritis in patients at different ages in china.

To determine the etiology of optic neuritis in patients of different ages in China. Records of optic neuritis patients who were hospitalized in the Department of Neuro-ophthalmology, General PLA Hospital, Beijing, between January 1, 2011 and December 31, 2011 were retrospectively reviewed. A total of 132 patients were divided into three groups by age. The percentage of patients aged ≤ 16 years, 16-45 years and >45 years were 17.4% (23/132), 54.6% (72/132), and 28.0% (37/132) respectively. The distribution of etiologies differed significantly among the three groups (X2=23.2, P=0.026). The percentage of idiopathic demyelinating optic neuritis was the highest in the 16-45 group (44.4%), and the proportion of neuromyelitis optical was the highest in the ≤ 16 years group. Infectious optic neuritis was more frequently seen in patients aged ≤ 16 years and >45 years. The source of infection was viral (n=2), nasosinusitis (n=1) and bacterial (n=1) in the ≤ 16 years group and neurosyphilis (n=3) and nasosinusitis (n=1) in the >45 years group. The percentage of paraneoplastic syndrome in the >45 years group was 8.11% (3/37). The etiology of optic neuritis in patients at various ages differed significantly.

The time course and phenotype of Uhthoff phenomenon following optic neuritis

As there is little information regarding the recovery from Uhthoff phenomenon (UP) in the multiple sclerosis (MS) literature, the objective of this study was to assess the phenotypes of UP. A one-page questionnaire was sent to 80 consecutive optic neuritis (ON) patients seen in a tertiary neuro-ophthalmology clinic. Of the 48 responders to the questionnaire, 52% reported experiencing UP, with a range of follow-up from 1 to 20 years. Only 16% had resolution of UP, all this occurred within 8 weeks of the onset of ON. Of the MS patients with UP, 88% experienced non-visual heat-related phenomenon compared with 30% without UP. The presence of UP may have a more general phenotypic significance. If full recovery from UP has not occurred within the first 2 months from the onset of ON, then recovery appears to be uncommon and may therefore be a surrogate marker of remyelination in future drug trials.

Neuromyelitis Optica Immunoglobulin G in Chinese Patients Detected by Immunofluorescence Assay on a Monkey Brain Substrate

Background: Serum neuromyelitis optica immunoglobulin G (NMO-IgG) is used as a biomarker to differentiate between neuromyelitis optica (NMO) and multiple sclerosis (MS). However, the original assay is expensive and complex and shows low sensitivity. Here, we investigated the potential of NMO-IgG detection using an indirect immunofluorescence (IIF) assay on monkey brains. Methods: NMO-IgG seroprevalence was determined in 168 samples by an IIF assay on a monkey brain substrate. The data were compared with those from a standard mouse brain IIF assay using McNemar and kappa tests. Results: Thirty-one of 50 (62%) NMO patients, 7 of 18 (38.9%) longitudinally extensive transverse myelitis patients, 6 of 57 (10.5%) MS patients, and 5 of 10 (50%) optic neuritis patients were seropositive for NMO-IgG. None of the acute partial transverse myelitis patients (n = 3) or healthy controls (n = 20) was positive. Thus, the sensitivity of the test was 62% for the patients with clinically definite NMO. The specificity was 89.5%, considering the 57 MS patients as the control group. The modified IIF assay on monkey brains and the standard IIF assay based on mouse brains were not significantly different (McNemar test; p = 1.000). The two assays were concordant in 39 seropositive samples and 100 seronegative samples (kappa test; kappa = 0.592, p < 0.0001). Conclusions: Although the modified IIF monkey brain assay was no better than the standard mouse brain IIF assay, we affirmed that NMO-IgG is a sensitive and specific biomarker to differentiate between NMO and MS.

Quantitative Analysis of Changes in Macular Layers Following Optic Neuritis

The effects of optic neuritis in patients with multiple sclerosis (MS) on the thickness of individual macular layers was analysed by means of optical coherence tomography (OCT). Data of 15 patients (mean age 37.2 years, range 16–50) with multiple sclerosis and 15 normal subjects (mean age 37.7 years, range 17–67) were analysed. Twelve patients had suffered from an attack of acute unilateral optic neuritis in one or both eyes. OCT scans of the circumpapillary retinal nerve fibre layer (RNFL) and of the macula were obtained by means of fast scan protocols. The characteristic sequence of five intensity maxima and four intensity minima was attributed to the mean location of the individual macular layers. The eyes affected by optic neuritis showed significant (p < 0.05) reductions of RNFL thickness by 30.5%, of macular volume (MV) by 12.8%, and of inner macular layers. The mean reduction was 16.2% (macular nerve fibre layer), 31.1% (ganglion cell layer [GCL]), and 25.9% (inner plexiform layer [IPL]), respectively. However, significant reductions of RNFL thickness (by 9.0%), MV (by 5.0%), CGL (by 10.3%), and IPL (by 10.8%) were found also in the unaffected eyes of MS patients. Thus, the quantitative analysis of the axial reflectivity profiles from exported OCT images offers an appropriate method for the characterisation of the location of macular changes after optic neuritis. The shrinking of inner macular layers is a more sensitive parameter of postneuritic optic atrophies than the reduction of MV.

Optic Neuritis: Visual Outcome and Risk Factors for the Development of Multiple Sclerosis in Western Turkey

Optic neuritis (ON) is highly associated with multiple sclerosis (MS) and conversion rate has been reported to be around 50% over a period of 15 years. We revised the risk factors for developing MS after an attack of ON, in western Turkey. One hundred and twenty-four patients with acute unilateral ON, who were on follow-up for at least 5 years (range 62 to180 months, mean 85 months) were enrolled in the study. Gender, age at onset, seasonal occurrence, severity of visual loss, presence of pain, optic disc appearance, treatment, degree of recovery, presence or absence of lesions on magnetic resonance imaging (MRI) during the initial ON attack and recurrence were considered. Of the 124 patients, 89 (71.8%) were women, 35 (28.2%) were men, with a mean age of 28.7 ± 8.6 years at the time of the initial ON attack. During follow-up, 70 patients (56.5%) developed MS within 17.14 months, ranging from 1 to 125 months. Female gender (p = 0.021), experiencing the attack before 40 years of age (p = 0.02), normal-appearing optic discs (p = 0.005), presence of MRI lesions (p < 0.001), and recurring ON attacks (p = 0.014) were significantly associated with a high risk of developing MS. The period for development of MS was significantly shorter in patients with MRI lesions (p < 0.001). Optic neuritis patients with brain MRI findings showing the morphological evidence of disseminated disease can be considered to have MS at the time of the initial ON attack, and disease-modifying treatments can be initiated.

Exploring the Association between Retinal Nerve Fiber Layer Thickness and Initial Magnetic Resonance Imaging Findings in Patients with Acute Optic Neuritis

Background. Recent studies have shown that OCT-measured retinal nerve fiber layer (RNFL) values may represent a marker for axonal damage in the anterior visual pathway of optic neuritis (ON) and multiple sclerosis (MS) patients. The goal of this study was to determine the link between RNFL values and initial magnetic resonance imaging (MRI) evidence of central nervous system (CNS) inflammation in patients with acute ON. Methods. Fifty patients who experienced ON as a clinically isolated syndrome (CIS) were followed for a mean period of 34 months with OCT testing. RNFL values in affected (ON) eyes and clinically unaffected (non-ON) eyes were compared between patients with MRI evidence of white matter lesions and those with normal baseline MRI findings, over a two year period. Findings. Twenty-one patients (42%) developed clinically definite MS (CDMS) during the study. After two years, temporal RNFL values were thinner (P = .07) in ON patients with MRI lesions at baseline, but the results were not significant. Conclusions. There is no association between RNFL values and baseline MRI status in ON patients at risk for future CDMS over a two year period.

Clinical Features and the Effect of High-Dose Steroid Therapy in Korean Optic Neuritis Patients

Clinical Features and the Effect of High-Dose Steroid Therapy in Korean Optic Neuritis Patients

Neuromyelitis optica and AQP4 antibodies in consecutive optic neuritis patients

Abstract Purpose To analyse the frequency of neuromyelitis optica (NMO) among consecutive optic neuritis (ON) patients in Southern Finland and to analyse correlation of Aquaporin‐4 (AQP4) antibody titre with the severity of ON and with the diagnosis of NMO. Methods All patients with symptoms suggestive of acute ON and treated in the Helsinki Eye Hospital have been screened for AQP4 antibodies from May 2008 onwards. Diagnosis of NMO among the ON patients was evaluated prospectively and retrospectively. AQP4 antibodies were measured using Radioimmunoprecipitation assay (Seelig‐lab). Antibody titres &gt;15 were considered pathological, 10‐15 borderline, and &lt;10 were considered normal. Brain magnetic resonance imaging (MRI) was performed in all patients. Results We screened 131 patients who had symptoms suggesting ON. Of the 131 patients 24 (18%) were eventually diagnosed with a condition other than ON. Of the remaining 107 patients classified as ON (77% females), 35 (33%) had multiple sclerosis (MS), 25 (23%) had demyelination by MRI, but did not fulfill the criteria for MS, and 47 (44%) had no MRI evidence of demyelination. The median AQP4 anti‐body titer was 7.3 (range 4.8‐53.5). Pathological AQP4 antibody titres were found in three cases, one with NMO, one with MS and one with a clinically isolated syndrome suggestive of MS fulfilling Barkhof’s MRI criteria. Borderline AQP4 antibody titres were found in 8 cases. Only one patient with NMO was found and he had pathological AQP4 antibody titer. Conclusion In the southern Finnish population, NMO is rare among ON patients. In this cohort the AQP4 antibody test was not specific for NMO.

In search for a magnocellular deficit in Optic Neuritis patients

In search for a magnocellular deficit in Optic Neuritis patients

Patterns of retinal nerve fiber layer loss in multiple sclerosis patients with or without optic neuritis and glaucoma patients

Objective Optical coherence tomography (OCT) has gained increasing attention in multiple sclerosis (MS) research and has been suggested as outcome measure for neuroprotective therapies. However, to date it is not clear whether patterns of retinal nerve fiber layer thickness (RNFLT) loss are different in MS compared to other diseases such as glaucoma and data on RNFLT loss in MS patients with or without optic neuritis (ON/NON) have remained inconsistent or even contradictory. Methods In this large cross-sectional study we analyzed the patterns of axonal loss of retinal ganglion cells in MS eyes ( n = 262) with and without history of ON (MS/ON: 73 eyes; MS/NON: 189 eyes) and patients eyes with glaucomatous optic disc atrophy (GA: n = 22; 39 eyes) in comparison to healthy control eyes (HC: n = 406 eyes). Results We found that significant average and quadrant RNFLT loss is detectable by OCT in both MS and GA patients compared to healthy controls ( p < 0.01). The age- and gender adjusted average and quadrant RNFLT did not differ significantly between MS and GA patients ( p > 0.05). Average ( p < 0.0001) and quadrant ( p < 0.05) RNFL thinning is significantly more severe in MS/ON versus MS/NON eyes, and the extent of RNFL thinning varies across quadrants in MS/ON eyes with the highest degree of RNFLT loss in the temporal quadrant ( p < 0.001). Conclusion RNFLT reduction across all four quadrants in MS patients as a whole as well as in MS/NON eyes argues for a diffuse neurodegenerative process. Superimposed inflammatory attacks to the optic nerve may cause additional axonal damage with a temporal preponderance. Future studies are necessary to further evaluate the capacity of OCT to depict disease specific damage patterns.

Treatment and nursing of idiopathic optic neuritis

Objective To observe the results of treating 67 idiopathic optic neuritis patients with large dose glucocorticoid and effective nursing intervention.Methods Sixty-seven cases of idiopathic optic neuritis patients were treated with combined modality therapy,practiced purposeful and planned mental nursing.More nursing experience was summarized from them.Results By our elaborative treatment,nursing and observation,most patients got vision improved.Conclusions Early medication was the basic treatment to rescue visual function.During the treatment,we should note the side effects of glucocorticoid,practiced planned mental nursing and health education,and enhance the consciousness of self health care as well. Key words: Idiopathic optic neuritis; Treatment; Nursing

Recurrent optic neuritis: clues from a long-term follow up study of recurrent and bilateral optic neuritis patients.

Optic neuritis (ON) can be recurrent, with unilateral or bilateral presentation. Diagnosis of recurrent cases may be challenging. In this study long-term follow-up of recurrent and/or bilateral ON patients is reported in an effort to guide differential diagnosis and treatment. The study included 474 optic neuropathy patients. Of these, 70 patients with recurrent unilateral or bilateral, and nonrecurrent bilateral ON were assessed. The characteristics of each ON attack, laboratory and magnetic resonance imaging (MRI) findings, associated diseases and response to treatment were noted for each patient. Most of the patients were reevaluated in the outpatient clinic. Seven patients were investigated for neuromyelitis optica (NMO)-immunoglobulin G (IgG) seropositivity. Forty-seven patients had recurrent unilateral ON and 23 had bilateral ON. Mean follow-up was 7.55 years. Final diagnoses for recurrent unilateral group were multiple sclerosis (MS) (n = 29), chronic relapsing inflammatory optic neuritis (CRION) (n = 11), NMO (n = 4), or autoimmune thyroid disease (n = 3); and for bilateral ON group, MS (n = 4), vasculitis (n = 13), postinfectious ON (n = 4), and sarcoidosis (n = 2). Three patients were positive for NMO antibodies. Based on the data collected, we conclude when recurrent ON causes moderate to severe visual loss in the absence of cranial MRI findings typical of MS, other diagnoses should be considered, including NMO.

Phosphorylated Neurofilament Heavy Chain Correlations to Visual Function, Optical Coherence Tomography, and Treatment

Objective. To correlate visual and neurologic clinical scores and treatment of optic neuritis and multiple sclerosis (MS) patients with assays of serum phosphorylated neurofilament heavy chain (pNF-H) and optical coherence tomography (OCT) measurements of axonal loss. Design/Methods. The Optic Neuritis Treatment Trial (ONTT) randomized 457 patients with acute optic neuritis to intravenous methylprednisolone (IVMP) followed by oral prednisone, oral prednisone or placebo treatment arms. We quantified serum pNF-H levels in 175 ONTT patients 5 years after study entry. We performed OCT measurements of macular volume and the retinal nerve fiber layer (RNFL) in a subset of 51 patients at year 15. Results. Elevated pNF-H levels at year 5 correlated to poorer visual function at study entry. Lower 15 year macular volumes and RNFL thickness correlated better with follow-up than with baseline visual function measures. With IVMP treatment, 15 year RNFL differences of the fellow eye (FE) minus the affected eye (SE) RNFLFEmSE correlated with five-year pNF-H levels. PNF-H was reduced by half with IVMP relative to placebo or by 40% relative to prednisone. Conclusions/Relevance. Acute optic neuritis patients who have more severe visual loss during initial presentation have a higher incidence of axonal loss that was slightly suppressed with IVMP treatment.

Is Skin Biopsy a Useful Investigation in the Diagnosis of Idiopathic Optic Neuritis?

Previous studies have recommended skin biopsy (the immunofluorescent “band” test) as a valuable tool in the identification of cases of optic neuritis which are autoimmune. However in recent years the diagnostic spectrum of optic neuritis not associated with multiple sclerosis (MS) has considerably expanded both following the description of specific syndromes and also the discovery of other means of identifying autoimmune optic neuritis (such as detecting antibodies to Aquaporin 4). Furthermore the value of the immunofluorescent band test in the diagnosis of systemic autoimmune disorders such as systemic lupus erythematosis (SLE) has been questioned. However the test could still be useful if it can be shown that there are cases of autoimmune optic neuritis patients who have a positive skin biopsy but have serological evidence for neither SLE nor for neuromyelitis optica (NMO).

Preliminary report of contrast sensitivity in idiopathic optic neuritis patients after recovery

To explore the changes of contrast sensitivity (CS) in patients recovered from idiopathic optic neuritis (ION). It was a case-control study. We screened 22 idiopathic optic neuritis patients who underwent treatment and obtained normal visual acuity. No nervous system abnormalities were found in MRI scan. Twenty four healthy individuals were enrolled as the control group. OPTEC 6500 contrast sensitivity tester was used to examine near- and far-distance CS values on 1.5, 3.0, 6.0, 12 and 18 cycles/degree (c/d), separately. T-test or u-test was used to compare the mean of CS values between these two groups. ANOVA or H-test was adopted on CS values at the different frequencies in each group. Simple linear correlation was used to analyze the correlation between CS values and age, duration and gender, separately. The maximum CS values in both far- and near-distance appeared in 6.0 c/d in these two groups were 70.27 +/- 40.44, 53.32 +/- 29.50, 78.86 +/- 36.37 and 109.39 +/- 44.98, respectively. The minimum CS values in both far- and near-distance appeared in 18 c/d in these two groups were 8.27 +/- 6.11, 12.09 +/- 8.57, 15.67 +/- 9.02 and 22.22 +/- 14.56, respectively. Far- and near-distance CS values in ION group and control group had very significant differences at these five spatial frequencies (From 1.5 to 18.0 c/d, the test values on far-distance were 4.19, 5.59, 3.06, 2.50, 3.13, P values were 0.00, 0.00, 0.00, 0.01, 0.00. The test values on near-distance were 3.54, 3.98, 2.72, 3.20, 3.39, P values were 0.00, 0.00, 0.01, 0.00, 0.00). CS values had no relation to the duration of ION. Significant difference in CS values existed on most frequencies (In far- and near-distance, H values in ION group were 52.38 and 64.96, in control group were 64.77 and 60.53, P values were both less than 0.01). The maximum H value appeared on near-distance in ION group. The maximum H value was 64.96 of near-distance in ION group. Far- and near-distance CS values in ION group itself and control group itself had very significant differences at these 5 spatial frequencies (From low to high frequencies, F values were 6.36, 0.03, 2.52, 1.53, 2.90; P values were 0.02, 0.87, 0.12, 0.22, 0.10 in ION group. In control group, F values were 5.31, 5.69, 6.06, 0.61, 3.14; P values were 0.03, 0.02, 0.02, 0.44, 0.08 respectively). CS values at different frequencies in ION patients with normal visual acuity descend significantly. Contrast sensitivity examination can be an important technique to evaluate vision quality in patients after ION.

Shift of temporal responsivity curve of pattern reversal visually evoked potentials to lower frequencies in patients after recovery from optic neuritis

To investigate the responsivity of the visual system to pattern reversal stimuli of different reversal rates in optic neuritis patients after a full recovery of visual acuity. Thirty eyes with optic neuritis and 30 eyes of age-matched normal controls were studied. Steady-state pattern reversal visually evoked potentials (P-VEPs) were recorded using reversal rates of 2, 10, 20 and 30 Hz. The relationship between the amplitudes of the P-VEPs and reversal rate was analysed. The temporal responsivity curves of the two groups were compared. The means ± standard deviations (SDs) of the P-VEP amplitudes in the normal controls were 7.08 ± 2.97, 8.60 ± 2.37, 4.69 ± 1.99 and 2.11 ± 1.24 μV at reversal rates of 2, 10, 20 and 30 Hz, respectively. The comparable amplitudes from the recovered optic neuritis patients were 8.01 ± 2.45, 6.57 ± 2.54, 2.73 ± 1.76 and 0.94 ± 1.27 μV. The mean amplitude of the P-VEPs elicited at a reversal rate of 2 Hz was not significantly different from that of normal controls. However, the amplitudes of the P-VEPs at reversal rates of 10, 20 and 30 Hz were significantly smaller in the recovered optic neuritis patients than in the controls. In addition, the average maximum amplitude of the P-VEPs was obtained at 10 Hz in normal subjects and at 2 Hz in the recovered optic neuritis patients. These results indicate that the peak of the temporal tuning curve of the P-VEP shifts to lower frequencies in recovered optic neuritis eyes, and that the reduced amplitudes at higher frequencies seem to be characteristic of the visual system of patients with recovered optic neuritis.