Pattern-reversal and flash electroretinograms (ERG) and visual evoked cortical potentials (VECP) were recorded from 15 patients with definite multiple sclerosis (MS). All patients had prolonged VECP latency, indicating demyelination of one or both optic nerves. The pattern-reversal ERG amplitude was reduced below the level of normal variation (mean -2 SD) in 11 of the 22 eyes with prolonged VECP latency and in one of the eight eyes with normal VECP latency. The mean pattern-reversal ERG amplitude from eyes with prolonged VECP latencies was significantly lower than the mean amplitude from the normal controls. No abnormalities were observed in the flash ERGs. Degeneration of retinal ganglion cell axons has been demonstrated in MS patients. The amplitude reduction in the pattern-reversal ERG, observed in some 50% of the eyes with prolonged VECP latencies, is supposed to reflect retinal ganglion cell dysfunction or degeneration secondary to demyelination of the optic nerve.
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