Structure and function of the visual pathway in multiple sclerosis

• Research type

  Research Study

• Full title

  A case control research project to investigate the function and structure of the complete visual pathway with routinely performed evoked potentials (pattern reversal ERGs and VEPs), and additional flash electroretinograms (FERGs) and optical coherence tomography (OCT) respectively, in patients suspected of having multiple sclerosis (MS).

• IRAS ID

  271835

• Contact name

  Nicola Broomfield

• Contact email

  nicola.broomfield@nhs.net

• Sponsor organisation

  University Hospital Plymouth NHS Trust

• Duration of Study in the UK

  1 years, 2 months, 1 days

• Research summary

  MS is a neurological condition that involves the brain and spinal cord, typically presenting between the ages of 20-40 years. The disease causes destruction of the myelin around the outside of the nerves (needed for impulses to be conducted), and the nerve axon itself. Most patients with MS, experience problems with their vision at some point during the disease, due to the myelin breakdown and slowed nerve conduction, which is detected with the visual evoked potential (VEP) test. This damage may also spread to involve the cells in the retina from which the optic nerves originate from, detected with the pattern electroretinogram (PERG) test. Although visual symptoms are common it has been shown that the damage detected with these tests may also be subclinical. For this reason, these tests represent the routine standards of care at UHPNT for patients being investigated for MS.

  More recently, there have been studies that suggest that the retinas of patients with MS may also be more widely affected, which we will test with an additional modality of evoked potential test, using flashes of light, called flash electroretinogram (FERG) tests. This study is to investigate further these abnormalities in patients suspected of having the disease that have not received any treatment. We will also use the results of the routine tests (VEP and PERG) to confirm optic nerve dysfunction in order to localise the site of abnormality.
  OCT images of the retinas will be taken to look for changes in structure of the retinal layers that may accompany the functional changes

  The additional FERG tests are the routine standards of care performed by the CI's department for the investigation of inherited and acquired diseases of the retina and are not new or novel tests.

• REC name

  South West - Cornwall & Plymouth Research Ethics Committee

• REC reference

  20/SW/0108

• Date of REC Opinion

  4 Aug 2020

• REC opinion

  Favourable Opinion