The use of optical coherence tomography and visual evoked potentials in the 2024 McDonald diagnostic criteria for multiple sclerosis
Open accessAbstract
The 2024 revisions of the McDonald diagnostic criteria include the optic nerve as a fifth anatomical location within the CNS for the diagnosis of multiple sclerosis, in addition to periventricular, juxtacortical or cortical, infratentorial, and spinal cord lesions. Demonstration of dissemination in space can now be achieved with the detection of typical lesions in at least two of these five locations. We review the evidence supporting the use of optical coherence tomography (OCT) and visual evoked potentials (VEPs) to show optic nerve involvement in the diagnosis of multiple sclerosis. We also report consensus recommendations for their use. Provided there is no better explanation for optic nerve involvement and that rigorous quality control is applied, OCT-derived peripapillary retinal nerve fibre layer inter-eye differences of 6 μm or greater or composite macular ganglion cell and inner plexiform layer inter-eye differences of 4 μm or greater support optic nerve injury. Delayed VEP latency, which depends on technical and methodological factors, and is centre and device dependent, supports demyelinating optic nerve injury when done with appropriate technical knowledge and interpretation.
AI snapshot
Written from the paper’s full text.
TL;DR
This Personal View from the IMSVISUAL consortium reviews the evidence that led the 2024 McDonald criteria to add the optic nerve as a fifth dissemination-in-space (DIS) region, and issues consensus recommendations for using OCT and VEPs to document optic nerve involvement. It recommends OCT inter-eye differences (IEDs) of ≥6 µm for pRNFL and/or ≥4 µm for GCIPL, and center-normed VEP P100 latency delay or inter-ocular asymmetry, applied only with rigorous quality control and clinical context.
Key findings
- An IMSVISUAL systematic review/meta-analysis of 5,776 MS eyes (1,667 with known prior ON, 4,109 without) and 1,697 healthy control eyes from 40 studies found mean pRNFL and GCIPL thicknesses of 104.4 µm and 70.03 µm in controls; pRNFL was 20.1 µm lower in MS eyes with prior ON and 7.41 µm lower without, and GCIPL was 16.42 µm and 7.75 µm lower, respectively.
- In a multicenter study (368 controls, 854 PwMS without known ON, 477 with prior unilateral ON), optimal IED thresholds were 5 µm for pRNFL (AUC 0.74) and 4 µm for GCIPL (AUC 0.77); device-specific pRNFL thresholds were 5 µm (Spectralis) and 6 µm (Cirrus), while GCIPL was ~4 µm for both. The consensus recommendation is pRNFL IED ≥6 µm and/or GCIPL IED ≥4 µm, approximating or exceeding the 95th percentile of control IEDs regardless of device.
- Adding the optic nerve improved diagnostic performance: Bsteh et al (n=267) reported accuracy rising from 65.6% to 81.2% in the subgroup with ≥5 years of follow-up (n=118); Vidal-Jordana et al (retrospective, 151 people, ≥10 years follow-up) reported accuracy 75.5%→78.1% and sensitivity 79.2%→82.3% with specificity unchanged.
- VEP P100 latency delays were detected in 77–100% of symptomatic eyes acutely and 62.2–80% after 12–24 months; abnormal VEPs occurred in 15–49% of clinically isolated syndrome patients, more often with ON (66.7–87%) than without (13.6–22.5%). Recommended VEP abnormality thresholds are 2.5 or 3 SD above the mean, based on each center's normative data.
Methods
- Consensus process: a December 2023 conference convened by the International Advisory Committee on Clinical Trials in MS (sponsored by ECTRIMS and the US NMSS) considered data-driven propositions to update the 2017 McDonald criteria; the committee voted unanimously to include the optic nerve as a fifth DIS location.
- Narrative review (Personal View) synthesizing OCT, VEP, and optic nerve MRI evidence, including IMSVISUAL meta-analyses and multicenter diagnostic-accuracy studies, with consensus recommendations and practical guidance (Panels 1–2, Tables 1–2).
- Literature identified via PubMed searches between April 2017 and December 2024 using terms including multiple sclerosis, optical coherence tomography, visual evoked potential, MRI, optic neuritis, and pediatric-onset/primary progressive MS.
Limitations
- Stated: bilateral optic nerve involvement may limit reliance on OCT IEDs alone, and there is insufficient evidence for individual-eye pRNFL/GCIPL measures or for z-scores (which warrant further investigation); there is insufficient evidence that change over time in OCT or VEP measures satisfies dissemination-in-time criteria; neither test is validated in pediatric MS, so optic nerve involvement in children should not be based solely on them; race and ethnicity effects remain understudied.
- Stated: the high diagnostic performance in supporting studies may reflect high OCT quality control, exclusion of participants with confounding ocular conditions and comorbidities, and enrollment of CIS patients at high risk for MS, limiting generalizability to people with vague symptoms or nonspecific white matter abnormalities; the supporting studies were conducted in adults.
- Stated: the 3D DIR optic nerve MRI studies cited are limited because that imaging is not routinely available and is not recommended in the 2024 McDonald criteria; VEP latency delay is not optic nerve specific (also seen in macular disorders and severe myopia), and VEP measures are center-, technique-, and device-dependent.
- Evident from the text: the diagnostic-accuracy studies cited are small and heterogeneous (n=118–267 in key subgroups; differing outcomes, follow-up durations, and paraclinical tests), and the specificity decreases seen in the prospective MAGNIMS study were attributed by the authors to short follow-up, treatment initiation, and embedding of the unmodified criteria in the primary outcome.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
26 of 37 cited sources checked · 9 supported · 0 flagged · accuracy not yet measured
- Premisecitation§ Consensus recommendations for using OCT or VEPs to detect optic nerve involvement in multiple sclerosis · p. 10
Optic nerve MRI with fat-saturation can better demonstrate symptomatic and asymptomatic T2 hyperintense optic nerve lesions than conventional brain MRIs.
“Optic nerve MRI with fat-saturation can better demonstrate symptomatic and asymptomatic T2hyperintense optic nerve lesions than conventional brain MRIs. 38”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [38] Petzold, 2022, Diagnosis and classification of optic neuritis, Lancet Neurol source
The Paraclinical criteria (p. 11) say MRI can show increased intrinsic signal in a symptomatic optic nerve. Our copy does not specify fat-saturation or T2-hyperintense lesions, address asymptomatic optic nerve lesions, or compare optic nerve MRI with conventional brain MRI. (LLM, conf=0.83)
Experimental — accuracy not yet measured
- Premisecitation§ Methods · p. 5
The 2024 revisions of the McDonald diagnostic criteria for multiple sclerosis include the optic nerve as a distinct fifth anatomical location for meeting dissemination in space criteria for relapsing- and progressive-onset MS.
“The committee voted unanimously to include the optic nerve as a distinct, fifth anatomical location for meeting dissemination in space (DIS) criteria for relapsingand progressive-onset MS. 25”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [25] Montalban, 2025, Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria, Lancet Neurol source
The indexed Abstract (page unavailable) says the 2024 criteria cover relapsing and progressive courses and that the optic nerve can serve as a fifth anatomical location for diagnosis. It does not state that the committee voted unanimously, as the citing sentence claims. (LLM, conf=0.83)
Experimental — accuracy not yet measured
- Premisecitation§ Detecting asymptomatic optic nerve lesions · p. 8
Asymptomatic optic nerve lesions detected with MRI are rarely seen in NMOSD or MOGAD.
“Of note, asymptomatic optic nerve lesions detected with MRI are rarely seen in NMOSD or MOGAD. 67,68”
Quote in the paperNot a substantial claim2 of 2 sources checked- cites [67] Tajfirouz, 2024, Frequency of asymptomatic optic nerve enhancement in 203 patients with MOG antibody-associated disease, Neurol Neuroimmunol Neuroinflamm source
The Discussion reports that new asymptomatic optic nerve enhancement was rare in MOGAD and cites a 2% rate in new locations in an NMOSD cohort. But the claim does not limit itself to new lesions: the paper reports asymptomatic enhancement in 13% of patients with MOGAD and 17% in that NMOSD cohort, and its Introduction notes a preliminary NMOSD report finding it in half of patients. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [68] Shah, 2022, Frequency of asymptomatic optic nerve enhancement in a large retrospective cohort of patients with aquaporin-4+ NMOSD, Neurology source
The Results and Discussion report that new asymptomatic optic nerve enhancement was rare in AQP4-IgG-positive NMOSD (about 2% of interattack scans). But asymptomatic enhancement overall appeared on 16.8% of interattack scans, mostly at sites of prior attacks, so the unqualified rarity claim overstates the finding. The paper does not study MOGAD. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
Several factors, including stimulus parameters, method of recording, and approaches for waveform analysis, influence VEPs, not only recorded latencies but also sensitivity to optic nerve lesions.
“Several factors, including the stimulus parameters used, method of recording, and approaches for waveform analysis, influence VEPs, not only the recorded latencies, but also the sensitivity to optic nerve lesions.”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [95] Janaky, 2017, VEP and PERG in patients with multiple sclerosis, with and without a history of optic neuritis, Doc Ophthalmol source
- cites [96] Lin, 2024, Individual prognostication of disease activity and disability worsening in multiple sclerosis with retinal layer thickness Z scores, Neurol Neuroimmunol Neuroinflamm source
The Methods (Optical Coherence Tomography; page unavailable) describe retinal OCT scans and segmentation, not visual evoked potentials. Searches for VEPs, stimulus parameters, waveform analysis, and optic-nerve-lesion sensitivity found no passage in our copy addressing the claimed effects on VEP latency or sensitivity. (LLM, conf=0.76)
Experimental — accuracy not yet measured
- Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
Co-morbidities such as poorly controlled hypertension and diabetes mellitus can affect OCT measures.
“Co-morbidities such as poorly controlled hypertension and diabetes mellitus, amongst others, can also affect OCT measures.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [89] Petzold, 2021, Retinal asymmetry in multiple sclerosis, Brain source
The Introduction identifies diabetes mellitus as a public-health condition known to affect OCT data. The cited passages do not identify hypertension as an OCT influence or address whether poor control of either condition matters. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
Tewarie and colleagues developed quality control guidelines for OCT in multiple sclerosis known as the OSCAR-IB criteria.
“Tewarie and colleagues developed quality control guidelines for OCT in MS -known as the OSCAR-IB criteria. 92”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [92] Tewarie, 2012, The OSCAR-IB consensus criteria for retinal OCT quality assessment, PLoS One source
- Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
The degree of pRNFL swelling during the acute phase of optic neuritis tends to be higher in MOGAD than in multiple sclerosis.
“Similarly, the degree of pRNFL swelling during the acute phase of ON tends to be higher in MOGAD than MS. 88”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [88] Chen, 2022, OCT retinal nerve fiber layer thickness differentiates acute optic neuritis from MOG antibody-associated disease and Multiple Sclerosis: RNFL thickening in acute optic neuritis from MOGAD vs MS, Mult Scler Relat Disord source
- Findingcitation§ Important considerations for the use of OCT and VEPs · p. 11
The multiple sclerosis diagnostic accuracy of inter-eye differences in OCT measures diminished according to the number and classes of co-morbidities present.
“Petzold et al found that the MS diagnostic accuracy of IEDs in OCT measures diminished according to the number and classes of co-morbidities present, highlighting the importance of interpreting OCT within the context of co-morbidities. 89”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [89] Petzold, 2021, Retinal asymmetry in multiple sclerosis, Brain source
- Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
People with NMOSD and MOGAD with known prior optic neuritis often have lower pRNFL and GCIPL thicknesses than people with multiple sclerosis who have had prior optic neuritis.
“The degrees of pRNFL and GCIPL thinning present may also be informative, since people with NMOSD and MOGAD with known prior ON often have lower pRNFL and GCIPL thicknesses than PwMS who have had prior ON. 84 -87”
Quote in the paperNot a substantial claim3 of 4 sources checked- cites [84] Roca-Fernandez, 2021, The use of OCT in good visual acuity MOGAD and AQP4-NMOSD patients; with and without optic neuritis, Mult Scler J Exp Transl Clin source
The Results (Macular sub-study cohort; page not provided) report lower pRNFL and GCIP measurements in MOGAD eyes with prior optic neuritis than in healthy controls. The study includes AQP4-NMOSD patients, but our copy does not establish the claimed thickness comparison for that group. It includes no multiple-sclerosis comparator, so it cannot support the claim that either disease group has lower thicknesses than people with MS after optic neuritis. (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites [85] Oertel, 2024, Retinal changes in double-antibody seronegative neuromyelitis optica spectrum disorders, Neurol Neuroimmunol Neuroinflamm source
The Results section, “Neuroaxonal Loss Dependent and Independent of ON” (page unavailable), reports thinner pRNFL and GCIPL in DN-NMOSD eyes after optic neuritis, but the comparator is healthy controls, not people with multiple sclerosis after optic neuritis. The Discussion describes pRNFL loss as comparable to values reported in MS; the paper does not establish lower thicknesses than in MS or report a MOGAD comparison. (LLM, conf=0.85)
Experimental — accuracy not yet measured - cites [86] Lin, 2021, Retinal optical coherence tomography and magnetic resonance imaging in neuromyelitis optica spectrum disorders and MOG-antibody associated disorders: an updated review, Expert Rev Neurother source
- cites [87] Sotirchos, 2020, Aquaporin-4 IgG seropositivity is associated with worse visual outcomes after optic neuritis than MOG-IgG seropositivity and multiple sclerosis, independent of macular ganglion cell layer thinning, Mult Scler source
- Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
Reliability and reproducibility of VEP recordings can be influenced by electrical noise, choice and placement of electrodes, impedance, and number of averages obtained per recording session.
“In addition, reliability and reproducibility of recordings can be influenced by electrical noise, the choice and placement of electrodes, impedance, and the number of averages obtained per recording session, among other factors. 95,96”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [95] Janaky, 2017, VEP and PERG in patients with multiple sclerosis, with and without a history of optic neuritis, Doc Ophthalmol source
- cites [96] Lin, 2024, Individual prognostication of disease activity and disability worsening in multiple sclerosis with retinal layer thickness Z scores, Neurol Neuroimmunol Neuroinflamm source
The Introduction and Methods > Optical Coherence Tomography discuss variation and quality control in OCT retinal-thickness measurements, not VEP recordings. Searches for VEP reliability, electrical noise, electrodes, impedance, and recording averages found no passage addressing the attributed claim. (LLM, conf=0.76)
Experimental — accuracy not yet measured
- Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 5, no optic nerve lesions were visible on optic nerve MRI.
“No optic nerve lesions were visible on optic nerve MRI.”
Quote in the paperSubstantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 6, no optic nerve lesion was detected on MRI.
“No optic nerve lesion was detected on MRI.”
Quote in the paperSubstantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 8, no optic nerve lesion was detected by MRI or OCT.
“Patient suffering from a first episode of acute myelitis about three months prior. No optic nerve lesion was detected by MRI or OCT.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 3: Patterns of peripapillary retinal nerve fiber layer (pRNFL), ganglion cell + inner plexiform layer (GCIPL) thinning and degrees of optic disc swelling in demyelinating optic neuropathies · p. 22
OCT exhibited mild pRNFL swelling, with 115 μm in the affected eye and 108 μm in the unaffected eye.
“OCT (not shown) exhibited mild pRNFL swelling (115µm in the affected eye and 108µm in the unaffected eye) .”
Quote in the paperNot a substantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20
No lesions were identified in the optic chiasms or optic tracts in any of the eight cases presented.
“No lesions were identified in the optic chiasms or optic tracts in any of these cases.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 6, left-sided temporal pRNFL thickness reduction is evident.
“Furthermore, left sided temporal pRNFL thickness reduction is also evident.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 8, by optic nerve MRI and OCT, there is no evidence of optic nerve involvement.
“Similar to Case n°7, by optic nerve MRI and OCT, there is no evidence of optic nerve involvement.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 3: Patterns of peripapillary retinal nerve fiber layer (pRNFL), ganglion cell + inner plexiform layer (GCIPL) thinning and degrees of optic disc swelling in demyelinating optic neuropathies · p. 22
In a patient with MS and a history of unilateral optic neuritis in the left eye more than 3 months previously, pRNFL thinning shows a temporal predominant pattern.
“pRNFL thinning shows a temporal predominant pattern (arrows demarcate pRNFL thinning temporally on the fundus photograph and thickness map).”
Quote in the paperNot a substantial claim - Findingnone given§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20
Each person included in the case series subsequently developed clinically definite MS during follow-up.
“Each person included in this series subsequently went on to develop clinically definite MS during follow-up.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 4, pRNFL and GCIPL inter-eye differences were below the proposed thresholds for optic nerve involvement.
“pRNFL and GCIPL IEDs were below the proposed thresholds for optic nerve involvement.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 4, only MRI detected an asymptomatic left-sided optic nerve lesion within the canalicular part.
“Only MRI detected an asymptomatic left sided optic nerve lesion within the canalicular part (yellow arrow).”
Quote in the paperNot a substantial claim - Findingnone given§ Figure 3: Patterns of peripapillary retinal nerve fiber layer (pRNFL), ganglion cell + inner plexiform layer (GCIPL) thinning and degrees of optic disc swelling in demyelinating optic neuropathies · p. 22
In a patient with NMOSD and a history of prior optic neuritis in each eye more than 3 months previously, OCT demonstrates severe global pRNFL thinning in both eyes.
“B: This OCT scan demonstrates severe global pRNFL thinning for both eyes, characteristic of neuromyelitis optica spectrum disorder (NMOSD) in a patient with history of prior ON in each eye more than 3-months previously.”
Quote in the paperNot a substantial claim - Findingown data§ Figure 3: Patterns of peripapillary retinal nerve fiber layer (pRNFL), ganglion cell + inner plexiform layer (GCIPL) thinning and degrees of optic disc swelling in demyelinating optic neuropathies · p. 22
The upper color fundus photographs demonstrate the subtle appearance of optic disc swelling in a person with MS and acute optic neuritis.
“The upper color fundus photographs demonstrate the subtle appearance of optic disc swelling (right eye, arrow points to superior disc elevation).”
Quote in the paperNot a substantial claim - Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 5, left temporal pRNFL atrophy is demonstrated.
“Furthermore, similar to many of the other cases presented in this series, left temporal pRNFL atrophy is demonstrated (yellow in the OCT reports represents values <5 th percentile, as compared age-matched healthy controls).”
Quote in the paperNot a substantial claim - Premisereasoning§ Summary · p. 4
Demonstration of dissemination in space for the diagnosis of MS can be achieved with the detection of typical lesions in at least two out of five regions, including the optic nerve.
“Demonstration of dissemination in space for the diagnosis of MS can now be achieved with the detection of typical lesions in at least two out of five of these regions.”
Quote in the paperSubstantial claim - Interpretationnone given§ Introduction · p. 5
OCT and VEPs are reliable paraclinical tests to identify both acute and prior optic nerve injury associated with MS.
“Optical coherence tomography (OCT) and visual evoked potentials (VEPs) are reliable paraclinical tests to identify both acute and prior optic nerve injury associated with MS.”
Quote in the paperNot a substantial claim - Interpretationreasoning§ Diagnostic performance when adding optic nerve involvement · p. 10
In patients with possible MS presenting with vague symptoms and/or nonspecific white matter abnormalities on brain MRI, the performance or added benefit of OCT and/or VEPs in the diagnosis of MS remains unknown.
“In these latter situations, the performance or added benefit of OCT and/or VEPs in the diagnosis of MS remains unknown.”
Quote in the paperSubstantial claim - Interpretationnone given§ Summary · p. 4
Delayed VEP latency supports demyelinating optic nerve injury when performed with appropriate technical knowledge and interpretation.
“Delayed VEP latency, which depends on technical and methodological factors, and is also center, and/or device dependent, supports demyelinating optic nerve injury when performed with appropriate technical knowledge and interpretation.”
Quote in the paperSubstantial claim - Premisecitation§ Consensus recommendations for using OCT or VEPs to detect optic nerve involvement in multiple sclerosis · p. 10
Both pre- and retro-chiasmal lesions can contribute to bilateral VEP abnormalities.
“Caution should be exercised when interpreting bilateral VEP delays, particularly when associated with abnormal morphology, since both pre- and retro- chiasmal lesions can contribute to bilateral VEP abnormalities. 46”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [46] Odom, 2016, ISCEV standard for clinical visual evoked potentials: (2016 update), Doc Ophthalmol source
- Interpretationnone given§ Summary · p. 4
Provided there is no better explanation for optic nerve involvement and rigorous quality-control is applied, OCT-derived peri-papillary retinal nerve fiber layer and/or composite macular ganglion cell and inner plexiform layer inter-eye differences of ≥6μm and ≥4μm respectively support prior optic nerve injury.
“Provided there is no better explanation for optic nerve involvement and that rigorous quality-control is applied, OCT-derived peri-papillary retinal nerve fiber layer and/or composite macular ganglion cell and inner plexiform layer inter-eye differences of ≥6µm and ≥4µm respectively, support prior optic nerve injury.”
Quote in the paperNot a substantial claim - Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11
High myopia (>6 diopters) can cause pRNFL and GCIPL thinning.
“Furthermore, high myopia (>6 diopters) can cause pRNFL and GCIPL thinning.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [78] Salehi, 2022, Associations of refractive errors and retinal changes measured by optical coherence tomography: a systematic review and meta-analysis, Surv Ophthalmol source
- Interpretationnone given§ Conclusions and future directions · p. 12
Neither VEPs nor OCT have been studied or validated to the same extent for their diagnostic utility in paediatric multiple sclerosis as compared to adult multiple sclerosis.
“Moreover, neither VEPs, nor OCT, have been studied or validated to the same extent for their diagnostic utility in paediatric MS, as compared to adult MS.”
Quote in the paperSubstantial claim - Interpretationnone given§ Conclusions and future directions · p. 12
The possibility of bilateral optic nerve involvement in people with multiple sclerosis may be a limitation of relying on OCT inter-eye differences alone for the determination of optic nerve involvement.
“The possibility of bilateral optic nerve involvement in PwMS may be a limitation of relying on OCT IEDs alone for the determination of optic nerve involvement (appendix pages 4-5).”
Quote in the paperSubstantial claim- Rests on an assumption: OCT-defined intereye differences have been validated for use at least 3 months after unilateral acute optic neuritis.
- Interpretationnone given§ Conclusions and future directions · p. 12
There is insufficient evidence that change in either OCT or VEP measures over time increases the specificity of multiple sclerosis diagnosis by satisfying traditional dissemination in time criteria.
“There is also insufficient evidence that change in either OCT or VEP measures over time increases the specificity of MS diagnosis, by satisfying traditional dissemination in time criteria.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
Case 6 is an example of MRI optic nerve negative but OCT positive optic nerve involvement.
“Similar to Case n°5, this case serves of an example of MRI optic nerve negative, but OCT positive optic nerve involvement.”
Quote in the paperNot a substantial claim - Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
Paraclinical tools have a complementary role for identifying optic nerve involvement.
“This case illustrates that optic nerve MRI does not always demonstrate visible optic nerve lesions, even when the OCT is clearly abnormal and supportive of optic nerve involvement, underpinning the complementary role of paraclinical tools for identifying optic nerve involvement.”
Quote in the paperSubstantial claim - Interpretationown data§ Figure 3: Patterns of peripapillary retinal nerve fiber layer (pRNFL), ganglion cell + inner plexiform layer (GCIPL) thinning and degrees of optic disc swelling in demyelinating optic neuropathies · p. 22
For this person with MS with acute onset of pain on eye movement as the only manifestation of acute optic neuritis, OCT was critical in confirming the presence of optic disc swelling that was subtle on direct ophthalmoscopy and color fundus photographs.
“For this person with MS with acute onset of pain on eye movement as the only manifestation of acute ON, OCT was critical in confirming the presence of optic disc swelling that was subtle on direct ophthalmoscopy and color fundus photographs as illustrated.”
Quote in the paperNot a substantial claim - Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
Optic nerve MRI does not always demonstrate visible optic nerve lesions, even when OCT is clearly abnormal and supportive of optic nerve involvement.
“This case illustrates that optic nerve MRI does not always demonstrate visible optic nerve lesions, even when the OCT is clearly abnormal and supportive of optic nerve involvement, underpinning the complementary role of paraclinical tools for identifying optic nerve involvement.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions and future directions · p. 13
Inclusion of optic nerve involvement improves the diagnostic performance of the 2017 McDonald diagnostic criteria in Hispanic people with suspected multiple sclerosis.
“Although it has been shown that the inclusion of optic nerve involvement improves the diagnostic performance of the 2017 McDonald diagnostic criteria in Hispanic people with suspected MS, the impact of race and ethnicity on the detection of optic nerve involvement for MS diagnosis currently remains understudied and should be a subject of future research. 98”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [98]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
In case 6, the pRNFL and GCIPL inter-eye differences confirmed a left-sided optic nerve lesion.
“pRNFL and GCIPL IEDs were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye, as compared to the right eye, confirming the presence of a left sided optic nerve lesion.”
Quote in the paperNot a substantial claim - Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20
In case 1, the pRNFL and GCIPL inter-eye differences confirmed right-sided optic nerve involvement.
“pRNFL and GCIPL IEDs were above the proposed thresholds and confirm right sided optic nerve involvement (lower pRNFL and GCIPL thicknesses in the right eye, as compared to the left eye).”
Quote in the paperNot a substantial claim - Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20
In case 3, the pRNFL and GCIPL inter-eye differences confirmed the presence of a left-sided optic nerve lesion.
“pRNFL and GCIPL IEDs were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye as compared to the right eye, confirming the presence of a left sided optic nerve lesion.”
Quote in the paperNot a substantial claim - Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
Not all visible optic nerve lesions on MRI are associated with significant inter-eye differences in pRNFL or GCIPL thickness measures.
“This case illustrates that not all visible optic nerve lesions on MRI are associated with significant IEDs in pRNFL or GCIPL thickness measures.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21
There may be scenarios in which there is clear optic nerve involvement, but either MRI or OCT are negative for detecting this involvement.
“This being said, based on the prior examples, there may be scenarios in which there is clear optic nerve involvement, but in which either MRI or OCT are negative for detecting this involvement.”
Quote in the paperSubstantial claim
- May combine two claims. 16
- Classified as probably not a substantial claim. 19
- The quote only partly states this claim. 3
May combine two claims.
Interpretationown data§ Detection of optic nerve involvement in multiple sclerosis using OCT and VEPs · p. 7Average pRNFL and GCIPL thicknesses are reduced in both MS eyes with and without known prior ON, and to a greater extent in those eyes with known prior ON.
“The findings of this meta-analysis show that average pRNFL and GCIPL thicknesses are reduced in both MS eyes with and without known prior ON, and as expected, to a greater extent in those eyes with known prior ON (appendix page 3).”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [50] Petzold, 2017, Retinal layer segmentation in multiple sclerosis: a systematic review and meta-analysis, Lancet Neurol source
- cites [51] Balcer, 2018, The International Multiple Sclerosis Visual System Consortium : advancing visual system research in multiple sclerosis, J Neuroophthalmol source
May combine two claims.
Findingcitation§ Diagnostic performance when adding optic nerve involvement · p. 9In the subgroup of people with at least 5-years of follow-up (n=118), the modified 2017 criteria improved diagnostic accuracy from 65.6% to 81.2%, with a modest increase in sensitivity and without change in specificity.
“In the subgroup of people with at least 5-years of follow-up (n=118), the modified 2017 criteria improved diagnostic accuracy from 65.6% to 81.2%, together with a modest increase in sensitivity, without change in specificity.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [75] Bsteh, 2023, Diagnostic performance of adding the optic nerve region assessed by optical coherence tomography to the diagnostic criteria for multiple sclerosis, Neurology source
The Results report that, among 118 patients with at least five years of follow-up, adding OCT to the dissemination-in-space (DIS) criteria increased diagnostic accuracy from 65.6% to 81.2% and sensitivity from 77.9% to 84.2%, with specificity unchanged at 52.2%. Those figures compare DIS criteria alone, not the full 2017 diagnostic criteria including dissemination in time (DIT). The Results say the improvement when DIT was included was smaller and not statistically significant. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
May combine two claims.
Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11Optic neuropathy can be caused by other inflammatory causes, such as MOGAD and NMOSD, as well as infectious, vascular, metabolic, nutritional, drug-induced, genetic and toxic causes.
“Optic neuropathy can be caused by other inflammatory causes, such as MOGAD and NMOSD, as well as infectious, vascular, metabolic, nutritional, drug-induced, genetic and toxic causes. 38,76,77”
Quote in the paperNot a substantial claim2 of 3 sources checked- cites [38] Petzold, 2022, Diagnosis and classification of optic neuritis, Lancet Neurol source
The Paraclinical criteria (p. 11) include AQP4 and MOG antibody positivity, and the Cases summary (p. 16) identifies NMO-associated and post-infectious optic neuritis. Our copy does not substantiate the remaining listed vascular, metabolic, nutritional, drug-induced, genetic, or toxic causes of optic neuropathy. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [76] Bennett, 2023, Optic neuritis and autoimmune optic neuropathies: advances in diagnosis and treatment, Lancet Neurol source
The paper’s opening summary identifies optic neuritis as an inflammatory optic neuropathy associated with MOGAD and NMOSD. The available passages do not substantiate the additional infectious, vascular, metabolic, nutritional, drug-induced, genetic, and toxic causes attributed to this source. (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites [77] Behbehani, 2007, Clinical approach to optic neuropathies, Clin Ophthalmol
Not checked in the free run.
May combine two claims.
Findingcitation§ Detection of optic nerve involvement in multiple sclerosis using OCT and VEPs · p. 7The optimal inter-eye difference threshold for identifying PwMS with known prior unilateral ON was 5μm for pRNFL (AUC = 0.74) and 4μm for GCIPL (AUC = 0.77) across OCT devices.
“The optimal IED threshold for identifying PwMS with known prior unilateral ON for the pRNFL was 5µm (AUC = 0.74) and GCIPL was 4µm (AUC = 0.77) across OCT devices.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [52] Nolan-Kenney, 2019, Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: an international study, Ann Neurol source
The available indexed passages identify the paper as a study of optimal intereye-difference thresholds, but do not report the claimed pRNFL and GCIPL thresholds or AUC values. Searches for unilateral optic neuritis, 5 μm, GCIPL, and AUC 0.74/0.77 found no passage that verifies those figures or the across-device qualifier. (LLM, conf=0.70)
Experimental — accuracy not yet measured
May combine two claims.
Findingcitation§ Diagnostic performance when adding optic nerve involvement · p. 9Overall, compared with the unmodified criteria, including the optic nerve resulted in an increase in sensitivity, with a slight decrease in specificity.
“Overall, compared with the unmodified criteria, including the optic nerve resulted in an increase in sensitivity, with a slight decrease in specificity.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [64] Vidal-Jordana, 2024, Adding the optic nerve in multiple sclerosis diagnostic criteria: a longitudinal, prospective, multicenter study, Neurology source
May combine two claims.
Premisecitation§ Consensus recommendations for using OCT or VEPs to detect optic nerve involvement in multiple sclerosis · p. 10In the 2024 McDonald criteria for multiple sclerosis diagnosis, the optic nerve is added to the four previously designated dissemination-in-space regions (periventricular, juxtacortical/cortical, infratentorial, spinal cord), and dissemination-in-space criteria can be met with involvement of at least 2 of these 5 regions.
“In the 2024 revisions of the McDonald criteria for diagnosis of multiple sclerosis, the optic nerve is added to the four previously designated DIS regions: peri-ventricular, juxta-cortical/cortical, infra-tentorial and spinal cord regions. DIS criteria for MS diagnosis can now be met with involvement of ≥ 2/5 of these regions (Panel 1). 25,26”
- Also stated in: § Conclusions and future directions · p. 12 · plain
“In the 2024 revisions of the McDonald criteria for the diagnosis of multiple sclerosis, there are five anatomical locations from which to assess for dissemination in space - peri-ventricular, juxta-cortical/cortical, infra-tentorial, spinal cord, and optic nerve regions. 25 DIS criteria are met with involvement of ≥ 2/5 of these regions.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [25] Montalban, 2025, Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria, Lancet Neurol source
Split into 2 atoms — 1 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured - cites [26] Barkhof, 2025, 2024 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI for the diagnosis of multiple sclerosis, Lancet Neurol source
- Also stated in: § Conclusions and future directions · p. 12 · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationcitation§ Important considerations for the use of OCT and VEPs · p. 11Assessing GCIPL thickness maps for patterns of regional macular injury might provide insight into vascular etiologies of optic neuropathy, such as when altitudinal thinning is present, or optic chiasm, optic tract, thalamic and/or retrogeniculate pathology.
“Assessing the GCIPL thickness maps for patterns of regional macular injury might provide insight into vascular etiologies of optic neuropathy, such as when altitudinal thinning is present, or optic chiasm, optic tract, thalamic and/or retrogeniculate pathology. 80 -83”
Quote in the paperNot a substantial claim3 of 4 sources checked- cites [80] MacIntosh, 2020, Acute changes in ganglion cell layer thickness in ischemic optic neuropathy compared to optic neuritis using optical coherence tomography, Int J Ophthalmol source
The Discussion (page not provided) reports altitudinal macular ganglion-cell-layer thinning in non-arteritic anterior ischemic optic neuropathy and says this pattern may help distinguish it from optic neuritis. It does not address whether GCIPL maps provide insight into optic chiasm, optic tract, thalamic, or retrogeniculate pathology, so that extension is unsupported by this paper. (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites [81] Erlich-Malona, 2016, Distinguishing ischaemic optic neuropathy from optic neuritis by ganglion cell analysis, Acta Ophthalmol source
- cites [82] Murphy, 2023, Trans-synaptic degeneration as a mechanism of neurodegeneration in multiple sclerosis, Neural Regen Res source
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured - cites [83] Al-Louzi, 2017, Retrograde trans-synaptic visual pathway degeneration in multiple sclerosis: a case series, Mult Scler source
The Discussion (page unavailable) says regional hemi-macular GCIP thinning may help localize injury in the lateral geniculate nucleus or posterior visual pathway; it reports optic-radiation and visual-cortex lesions and notes that terminal optic-tract involvement could not be excluded. This supports the thalamic and retrogeniculate parts of the claim, but the paper does not address optic-chiasm pathology, vascular optic neuropathy, or altitudinal thinning. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11Anisometropia may have the potential to cause apparent inter-eye differences.
“Anisometropia may have the potential to cause apparent IEDs. 79”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [79] Wang, 2022, Assessment of macular structures and vascular characteristics in highly myopic anisometropia using swept-source optical coherence tomography angiography, Front Physiol source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 2, only the GCIPL inter-eye difference was considered abnormal, with GCIPL thickness lower in the left eye.
“Only the IED of the GCIPL was considered abnormal, with the GCIPL thickness being lower in the left eye.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingcitation§ Panel D: Post-chiasmal afferent visual pathway involvement by demyelinating lesions · p. 22MRI demonstrated an enhancing lesion in the right thalamus and optic tract.
“MRI demonstrated an enhancing lesion in the right thalamus and optic tract.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 3, pRNFL and GCIPL inter-eye differences were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye than the right eye.
“pRNFL and GCIPL IEDs were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye as compared to the right eye, confirming the presence of a left sided optic nerve lesion.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 2, MRI demonstrated bilateral asymptomatic optic nerve lesions, with at least two discrete lesions evident within the left optic nerve.
“MRIs demonstrate bilateral asymptomatic optic nerve lesions, with at least two discrete lesions evident within the left optic nerve (yellow arrows; orbital section of the right, and orbital + canalicular sections of the left optic nerve).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims. The quote only partly states this claim.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 5, pRNFL and GCIPL inter-eye differences were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye than the right eye.
“pRNFL and GCIPL IEDs were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye as compared to the right eye, confirming the presence of a left sided optic nerve lesion.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Panel D: Post-chiasmal afferent visual pathway involvement by demyelinating lesions · p. 22There was no history of acute unilateral optic neuritis in this patient.
“There was no history of acute unilateral ON.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21In case 7, no optic nerve lesion was detected by MRI or OCT.
“No optic nerve lesion was detected by MRI or OCT.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21In case 8, inter-eye differences remained below the proposed thresholds.
“No optic nerve lesion was detected by MRI or OCT. IEDs remain below the proposed thresholds.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 1, MRI showed a symptomatic right-sided optic nerve lesion within the orbital region.
“On MRI, we observed a symptomatic right sided optic nerve lesion within the orbital region (red arrow).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 3, MRI highlighted a left asymptomatic optic nerve lesion.
“MRI highlighted a left asymptomatic optic nerve lesion (yellow arrow).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingcitation§ Panel D: Post-chiasmal afferent visual pathway involvement by demyelinating lesions · p. 22This OCT scan demonstrates hemi-macular thinning of the GCIPL.
“This OCT scan demonstrates hemi-macular thinning of the GCIPL.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 1, pRNFL and GCIPL inter-eye differences were above the proposed thresholds, with lower pRNFL and GCIPL thicknesses in the right eye than the left eye.
“pRNFL and GCIPL IEDs were above the proposed thresholds and confirm right sided optic nerve involvement (lower pRNFL and GCIPL thicknesses in the right eye, as compared to the left eye).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingcitation§ Panel D: Post-chiasmal afferent visual pathway involvement by demyelinating lesions · p. 22The patient had relapsing MS and presented with a left homonymous visual field defect.
“The patient had relapsing MS and presented with a left homonymous visual field defect.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21In case 6, pRNFL and GCIPL inter-eye differences were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye than the right eye.
“pRNFL and GCIPL IEDs were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye, as compared to the right eye, confirming the presence of a left sided optic nerve lesion.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 21In case 7, inter-eye differences remained below the proposed thresholds.
“IEDs remain below the proposed thresholds.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone given§ Methods · p. 5There is ample evidence to support the clinical use of OCT, VEPs, and/or optic nerve MRI to objectively identify optic nerve involvement for the diagnosis of MS.
“Furthermore, it was recognised that there is ample evidence to support the clinical use of optical coherence tomography (OCT), visual evoked potentials (VEPs), and/or optic nerve MRI, to objectively identify optic nerve involvement for the diagnosis of MS.”
Quote in the paperNot a substantial claimMay combine two claims.
Premisecitation§ Important considerations for the use of OCT and VEPs · p. 11Different patterns of pRNFL thinning tend to be observed: superior-inferior predominant in myopia and temporal predominant in multiple sclerosis.
“Different patterns of pRNFL thinning tend to be observed, i.e. superior-inferior predominant in myopia and temporal predominant pattern in MS (Figure 3 and supplementary figure 1 in appendix; pages 11-12). 78”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [78] Salehi, 2022, Associations of refractive errors and retinal changes measured by optical coherence tomography: a systematic review and meta-analysis, Surv Ophthalmol source
May combine two claims.
Interpretationreasoning§ Diagnostic performance when adding optic nerve involvement · p. 10The high diagnostic performance of the modified DIS criteria in these studies may have been a product of the high quality-control of OCT, the exclusion of participants with potentially confounding ocular conditions and other comorbidities, and the enrolment of people with CIS at high-risk for developing MS, which might limit the generalisability of the findings.
“The high diagnostic performance of the modified DIS criteria in these studies may have been a product of the high-QC of OCT, the exclusion of participants with potentially confounding ocular conditions and other comorbidities, as well as the enrolment of people with CIS at high-risk for developing MS, which might limit the generalisability of the findings.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationnone given§ Optical coherence tomography and visual evoked potentials · p. 6An important limitation of measuring VEP latency delay, particularly when mild, is that it is not optic nerve specific; delays can also be detected in certain retinal disorders, especially those involving the macula, and in refractive abnormalities such as severe myopia.
“However, an important limitation of measuring VEP latency delay, particularly when mild, is that it is not optic nerve specific. Delays can also be detected in certain retinal disorders, especially those involving the macula, and in refractive abnormalities such as severe myopia.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Interpretationcitation§ Important considerations for the use of OCT and VEPs · p. 11Following well-established guidelines such as the ISCEV and IFCN standards likely improves VEP reliability and comparability across clinical laboratories.
“We recommend following well-established guidelines to ensure the use of appropriate parameters for performing VEPs in the clinic, such as the widely used standards from the International Society for Clinical Electrophysiology of Vision and the International Federation of Clinical Neurophysiology, which have likely contributed to improve VEP reliability and comparability across clinical laborator”
Quote in the paperNot a substantial claim0 of 2 sources checkedThe quote only partly states this claim.
Interpretationown data§ Figure 2: Optic nerve lesions detected by optical coherence tomography and matching optic nerve MRIs · p. 20In case 5, the pRNFL and GCIPL inter-eye differences confirmed the presence of a left-sided optic nerve lesion.
“pRNFL and GCIPL IEDs were above the proposed thresholds, with both pRNFL and GCIPL thickness measures lower in the left eye as compared to the right eye, confirming the presence of a left sided optic nerve lesion.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Interpretationnone given§ Conclusions and future directions · p. 12There is currently insufficient evidence regarding individual eye derived measures of pRNFL or GCIPL thicknesses to establish consensus recommendations.
“However, there is currently insufficient evidence regarding individual eye derived measures of pRNFL or GCIPL thicknesses to establish consensus recommendations.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Interpretationnone given§ Conclusions and future directions · p. 12Concurrent ophthalmologic and/or neurologic disorders that may produce similar OCT and/or VEP findings to those seen in multiple sclerosis may preclude the use of these tools in multiple sclerosis diagnosis in certain cases.
“Concurrent ophthalmologic and/or neurologic disorders that may produce similar OCT and/or VEP findings to those seen in MS may preclude the use of these tools in MS diagnosis in certain cases.”
Quote in the paperSubstantial claim- Rests on an assumption: OCT and VEP findings are not disease-specific.
Classified as probably not a substantial claim.
Interpretationcitation§ Conclusions and future directions · p. 13The impact of race and ethnicity on the detection of optic nerve involvement for multiple sclerosis diagnosis currently remains understudied.
“Although it has been shown that the inclusion of optic nerve involvement improves the diagnostic performance of the 2017 McDonald diagnostic criteria in Hispanic people with suspected MS, the impact of race and ethnicity on the detection of optic nerve involvement for MS diagnosis currently remains understudied and should be a subject of future research. 98”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone given§ Considerations when selecting OCT or VEPs: time elapsed since acute ON · p. 16OCT has not yet been validated for the impact of detecting bilateral optic nerve involvement for the purpose of aiding the diagnosis of multiple sclerosis.
“Note that OCT has not yet been validated for the impact of detecting bilateral optic nerve involvement for the purpose of aiding the diagnosis of MS.”
Quote in the paperNot a substantial claim- Rests on an assumption: OCT-defined intereye differences have been validated for use at least 3 months after unilateral acute optic neuritis.
The paper relies on this without support.
pRNFL intereye difference ≥6 µm and/or composite GCIPL intereye difference ≥4 µm approximate or exceed the 95th percentile for intereye differences in healthy controls, regardless of OCT device.
“These recommendations approximate or exceed the 95 th percentile for IEDs in healthy controls, regardless of OCT device.”
The paper relies on this without support.
VEP P100 latency delay or asymmetric inter-ocular VEP latencies (2.5 or 3 SD above the mean) might support the presence of demyelinating optic nerve injury.
“VEP P100 latency delay or asymmetric inter-ocular VEP latencies (2.5 or 3 SD above the mean in both cases) might similarly support the presence of demyelinating optic nerve injury.”
The paper relies on this without support.
The exact numerical measures of VEPs depend on technical and methodological factors and are center and/or device dependent.
“However, the exact numerical measures of VEPs depend on technical and methodological factors, and are also center, and/or device dependent.”
The paper relies on this without support.
The OSCAR-IB guidelines are now used both for OCT optic nerve scans, from which pRNFL thickness is derived, and macular scans, from which GCIPL thickness is derived.
“The guidelines are now used both for OCT optic nerve scans, from which pRNFL thickness is derived, and macular scans, from which GCIPL thickness is derived.”
The paper relies on this without support.
The OSCAR-IB guidelines were developed for use in people with known multiple sclerosis participating in clinical trials, and to be used by trained readers.
“These guidelines were developed for use in people with known MS participating in clinical trials, and to be used by trained readers.”
The paper relies on this without support.
OCT and VEP findings are not disease-specific.
“Note that OCT and VEP findings are not disease-specific. Define optic nerve lesions after ruling out other possible explanations for OCT and/or VEP findings.”
The paper relies on this without support.
VEPs are more sensitive in the acute phase of optic neuritis, as latency often improves over time following optic neuritis due to remyelination.
“VEPs are more sensitive in the acute phase of ON, as latency often improves over time following ON due to remyelination”
The paper relies on this without support.
OCT-defined intereye differences have been validated for use at least 3 months after unilateral acute optic neuritis.
“OCTdefined IEDs have been validated for use ≥ 3 months after unilateral acute ON.”
The paper relies on this without support.
During episodes of inflammatory demyelination of the optic nerve, whether symptomatic or asymptomatic, permanent injury to the affected optic nerve axons typically occurs.
“During episodes of inflammatory demyelination of the optic nerve, whether symptomatic or asymptomatic, permanent injury to the affected optic nerve axons typically occurs.”
The paper relies on this without support.
Inflammatory demyelination injury to the optic nerve results in retrograde, anterograde (Wallerian), and trans-synaptic axonal degeneration.
“This injury results in retrograde (toward the retina), anterograde (Wallerian), and trans-synaptic axonal degeneration.”
The paper relies on this without support.
The sensitivity of optic nerve MRI for detecting optic nerve lesions reduces over time from the formation of demyelinating optic nerve lesions.
“It should be noted that the sensitivity of optic nerve MRI for detecting optic nerve lesions reduces over time from the formation of demyelinating optic nerve lesions.”
The paper relies on this without support.
The sensitivity of VEP latencies for detecting optic nerve demyelinating lesions may diminish over time from their formation.
“While VEPs can also have a complementary role or serve as an alternative basis to OCT and/or optic nerve MRI for the identification of optic nerve involvement, the sensitivity of VEP latencies for detecting optic nerve demyelinating lesions may also diminish over time from their formation.”
The paper relies on this without support.
Some of the earliest signs of optic disc swelling are loss of visibility of the capillaries, a more curved (looped) course of the larger retinal vessels over the elevated disc margin, and engorged veins.
“Some of the earliest signs of optic disc swelling are loss of visibility of the capillaries (due to being covered by the swollen pRNFL, giving the impression of a blurred disc margin, a more curved (looped) course of the larger retinal vessels over the elevated disc margin, and engorged veins.”
The paper relies on this without support.
VEPs can have a complementary role or serve as an alternative basis to OCT and/or optic nerve MRI for the identification of optic nerve involvement.
“While VEPs can also have a complementary role or serve as an alternative basis to OCT and/or optic nerve MRI for the identification of optic nerve involvement, the sensitivity of VEP latencies for detecting optic nerve demyelinating lesions may also diminish over time from their formation.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Under the 2024-revised criteria, MS can be diagnosed when ≥4 typical topographies are affected.
“MS can be diagnosed when ≥4 typical topographies are affected.8, 9, 10”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [10]
The Summary (p. 4) and Conclusions (p. 12) say that involvement of at least two of five anatomical regions meets the revised dissemination-in-space criterion, so four affected regions would meet that criterion. They do not state that four affected regions alone are sufficient to diagnose MS. (LLM, conf=0.85)
Experimental — accuracy not yet measuredOCT is emerging as a robust prognostic biomarker in MS and was also suggested to be applicable for treatment decisions and differential diagnosis.
“Further, OCT is emerging as a robust prognostic biomarker in MS and was also suggested to be applicable for treatment decisions and differential diagnosis.”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [10]
The section ‘Optical coherence tomography and visual evoked potentials’ (p. 6) says OCT may show patterns that help distinguish NMOSD- or MOGAD-related optic neuritis, supporting a role in differential diagnosis. The paper chiefly addresses OCT for MS diagnosis; its discussion of relapse risk (p. 9) does not establish OCT as a robust prognostic biomarker, and the searched passages do not suggest using it for treatment decisions. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe optic nerve is incorporated as the fifth neuroanatomical topography for establishing DIS in the 2024-revised McDonald criteria.
“The optic nerve is incorporated as the fifth neuroanatomical topography for establishing DIS, complementing periventricular, (juxta-)cortical, infratentorial, and spinal cord regions.8, 9, 10”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [10]
Optic nerve involvement can be substantiated by VEP, OCT, or MRI in the 2024-revised criteria.
“Optic nerve involvement can be substantiated by visual evoked potentials (VEP), optical coherence tomography (OCT), or MRI thus formally integrating visual pathway assessment into the diagnostic framework.8, 9, 10”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [10]
In CSF, intrathecal inflammation can be demonstrated by oligoclonal bands (OCB) or by kappa free light chains (KFLC).
“in CSF, intrathecal inflammation can be demonstrated by oligoclonal bands (OCB) or by kappa free light chains (KFLC), which represent a complementary biomarker.8, 9, 10, 11, 12”
From Applying the 2024-revised McDonald criteria for multiple sclerosis using conventional diagnostic tools: a single-centre prospective cohort study in Germany (2026) · cites this paper as [10]
The Summary (p. 4) and Conclusions (p. 12) discuss OCT and visual evoked potentials for detecting optic nerve involvement, not CSF markers of intrathecal inflammation. Searches for kappa free light chains, CSF, and oligoclonal bands found only references mentioning oligoclonal banding (pp. 30–31), with no passage establishing the claimed OCB-or-KFLC relationship. (LLM, conf=0.72)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Citation 101 exceeds the stated reference list
MinorThe manuscript cites reference 101, but states that it has 98 references; the provided list ends at reference 98.
“In addition, further work is needed to assess whether VEPs and OCT in combination improves MS diagnostic performance, over either technique alone, together with measures of visual function such as low-contrast letter acuity. 101”
“Number of References: 98”
Cites
Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria
Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., Correale, J., Fazekas, F., Filippi, M., Freedman, M. S., et al. (2018) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30470-2 · Cited by 8,167 · see citing works
Self-citationMcDonald, W. I., Compston, A., Edan, G., Goodkin, D., Hartung, H., Lublin, F. D., McFarland, H. F., Paty, D. W., Polman, C. H., Reingold, S. C., et al. (2001) · Annals of Neurology · doi:10.1002/ana.1032 · Cited by 6,969 · see citing works
Self-citationRemyelination in the CNS: from biology to therapy
Franklin, R. J. M., & ffrench-Constant, C. (2008) · Nature Reviews Neuroscience · doi:10.1038/nrn2480 · Cited by 1,544 · see citing works
Pathological mechanisms in progressive multiple sclerosis
Mahad, D., Trapp, B. D., & Lassmann, H. (2015) · The Lancet Neurology · doi:10.1016/s1474-4422(14)70256-x · Cited by 1,148 · see citing works
ISCEV standard for clinical visual evoked potentials: (2016 update)
International Society for Clinical Electrophysiology of Vision, Odom, J. V., Bach, M., Brigell, M., Holder, G. E., McCulloch, D. L., Mizota, A., & Tormene, A. P. (2016) · Documenta Ophthalmologica · doi:10.1007/s10633-016-9553-y · Cited by 699 · see citing works
Paty, D. W., Oger, J. J.-F., Kastrukoff, L. F., Hashimoto, S. A., Hooge, J. P., Eisen, A., Eisen, K., Purves, S., Low, M. D., Brandejs, V., et al. (1988) · Neurology · doi:10.1212/wnl.38.2.180 · Cited by 635 · see citing works
The OSCAR-IB Consensus Criteria for Retinal OCT Quality Assessment
Tewarie, P., Balk, L., Costello, F., Green, A., Martin, R., Schippling, S., & Petzold, A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0034823 · Cited by 627 · see citing works
Self-citationOptical coherence tomography in multiple sclerosis: a systematic review and meta-analysis
Petzold, A., de Boer, J. F., Schippling, S., Vermersch, P., Kardon, R. H., Green, A., Calabresi, P. A., & Polman, C. H. (2010) · The Lancet Neurology · doi:10.1016/s1474-4422(10)70168-x · Cited by 595 · see citing works
Self-citationRetinal layer segmentation in multiple sclerosis: a systematic review and meta-analysis
Petzold, A., Balcer, L. J., Calabresi, P. A., Costello, F., Frohman, T. C., Frohman, E. M., Martinez-Lapiscina, E. H., Green, A. J., Kardon, R., Outteryck, O., et al. (2017) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30278-8 · Cited by 585 · see citing works
Self-citationDiagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria
Montalban, X., Lebrun-Frénay, C., Oh, J., Arrambide, G., Moccia, M., Pia Amato, M., Amezcua, L., Banwell, B., Bar-Or, A., Barkhof, F., et al. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00270-4 · Cited by 551 · see citing works
Self-citationNadal-Nicola´s, F. M., Jime´nez-Lo´pez, M., Sobrado-Calvo, P., Nieto-Lo´pez, L., Ca´novas-Marti´nez, I., Salinas-Navarro, M., Vidal-Sanz, M., & Agudo, M. (2009) · Investigative Opthalmology & Visual Science · doi:10.1167/iovs.08-3267 · Cited by 541 · see citing works
Green, A. J., McQuaid, S., Hauser, S. L., Allen, I. V., & Lyness, R. W. (2010) · Brain · doi:10.1093/brain/awq080 · Cited by 489 · see citing works
Self-citationVillegas‐Pérez, M., Vidal‐Sanz, M., Rasminsky, M., Bray, G. M., & Aguayo, A. J. (1993) · Journal of Neurobiology · doi:10.1002/neu.480240103 · Cited by 455 · see citing works
Mechanisms of Neuronal Dysfunction and Degeneration in Multiple Sclerosis
Dutta, R., & Trapp, B. (2010) · Progress in neurobiology · doi:10.1016/j.pneurobio.2010.09.005 · Cited by 453 · see citing works
Mwanza, J.-C., Oakley, J. D., Budenz, D. L., et al. (2011) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.11-7962 · Cited by 430 · see citing works
The APOSTEL recommendations for reporting quantitative optical coherence tomography studies
Cruz-Herranz, A., Balk, L. J., Oberwahrenbrock, T., Saidha, S., Martínez‐Lapiscina, E. H., Lagrèze, W. A., Schuman, J. S., Villoslada, P., Calabresi, P. A., Balcer, L. J., et al. (2016) · Neurology · doi:10.1212/wnl.0000000000002774 · Cited by 418 · see citing works
Self-citationRamon, P. P., Salvador, M., Villegas-Pérez, M. P., & Vidal‐Sanz, M. (1996) · PubMed · Cited by 399 · see citing works
Optical coherence tomography reflects brain atrophy in multiple sclerosis: A four‐year study
Saidha, S., Al‐Louzi, O., Ratchford, J. N., Bhargava, P., Oh, J., Newsome, S. D., Prince, J. L., Pham, D. L., Roy, S., van Zijl, P. C. M., et al. (2015) · Annals of Neurology · doi:10.1002/ana.24487 · Cited by 390 · see citing works
Self-citationBalcer, L. J. (2006) · New England Journal of Medicine · doi:10.1056/nejmcp053247 · Cited by 390 · see citing works
Self-citationPrimary retinal pathology in multiple sclerosis as detected by optical coherence tomography
Saidha, S., Syc‐Mazurek, S. B., Ibrahim, M., Eckstein, C. P., Warner, C. V., Farrell, S. K., Oakley, J. D., Durbin, M. K., Meyer, S. A., Balcer, L. J., et al. (2011) · Brain · doi:10.1093/brain/awq346 · Cited by 334 · see citing works
Self-citationDiagnosis and classification of optic neuritis
Petzold, A., Fraser, C. L., Abegg, M., Alroughani, R., Alshowaeir, D., Alvarenga, R., Andris, C., Asgari, N., Barnett, Y., Battistella, R., et al. (2022) · The Lancet Neurology · doi:10.1016/s1474-4422(22)00200-9 · Cited by 330 · see citing works
Self-citationOptical coherence tomography: a window into the mechanisms of multiple sclerosis
Frohman, E. M., Fujimoto, J. G., Frohman, T. C., Calabresi, P. A., Cutter, G., & Balcer, L. J. (2008) · Nature Clinical Practice Neurology · doi:10.1038/ncpneuro0950 · Cited by 326 · see citing works
Self-citationQuality control for retinal OCT in multiple sclerosis: validation of the OSCAR-IB criteria
Schippling, S., Balk, L., Costello, F., Albrecht, P., Balcer, L. J., Calabresi, P. A., Frederiksen, J. L., Frohman, E. M., Green, A. J., Klistorner, A. I., et al. (2014) · Multiple Sclerosis Journal · doi:10.1177/1352458514538110 · Cited by 310 · see citing works
Self-citationSaidha, S., Syc‐Mazurek, S. B., Durbin, M. K., Eckstein, C. P., Oakley, J. D., Meyer, S. A., Conger, A., Frohman, T. C., Newsome, S. D., Ratchford, J. N., et al. (2011) · Multiple Sclerosis Journal · doi:10.1177/1352458511418630 · Cited by 297 · see citing works
Self-citationCadavid, D., Balcer, L. J., Galetta, S. L., Aktaş, O., Ziemssen, T., Vanopdenbosch, L. J., Frederiksen, J. L., Skeen, M. B., Jaffe, G. J., Butzkueven, H., et al. (2017) · The Lancet Neurology · doi:10.1016/s1474-4422(16)30377-5 · Cited by 274 · see citing works
Self-citationDistribution of plaques in seventy autopsy cases of multiple sclerosis in the United States
Ikuta, F., & Zimmerman, H. M. (1976) · Neurology · doi:10.1212/wnl.26.6_part_2.26 · Cited by 237 · see citing works
Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning
Ratchford, J. N., Saidha, S., Sotirchos, E. S., Oh, J., Seigo, M. A., Eckstein, C. P., Durbin, M. K., Oakley, J. D., Meyer, S. A., Conger, A., et al. (2012) · Neurology · doi:10.1212/wnl.0b013e31827b1a1c · Cited by 235 · see citing works
Self-citationAPOSTEL 2.0 Recommendations for Reporting Quantitative Optical Coherence Tomography Studies
Aytulun, A., Cruz-Herranz, A., Aktaş, O., Balcer, L. J., Balk, L. J., Barboni, P., Azuara‐Blanco, A., Calabresi, P. A., Costello, F., Sánchez-Dalmau, B. F., et al. (2021) · Neurology · doi:10.1212/wnl.0000000000012125 · Cited by 233 · see citing works
Self-citationSaidha, S., Sotirchos, E. S., Oh, J., Syc‐Mazurek, S. B., Seigo, M. A., Shiee, N., Eckstein, C., Durbin, M. K., Oakley, J. D., Meyer, S. A., et al. (2013) · JAMA Neurology · doi:10.1001/jamaneurol.2013.573 · Cited by 231 · see citing works
Self-citationOptic neuritis and autoimmune optic neuropathies: advances in diagnosis and treatment
Bennett, J. L., Costello, F., Chen, J. J., Petzold, A., Biousse, V., Newman, N. J., & Galetta, S. L. (2023) · The Lancet Neurology · doi:10.1016/s1474-4422(22)00187-9 · Cited by 226 · see citing works
Self-citationThe time course of retrograde trans-synaptic degeneration following occipital lobe damage in humans
Jindahra, P., Petrie, A., & Plant, G. T. (2012) · Brain · doi:10.1093/brain/awr324 · Cited by 212 · see citing works
CNS remyelination and inflammation: From basic mechanisms to therapeutic opportunities
Franklin, R. J. M., & Simons, M. (2022) · Neuron · doi:10.1016/j.neuron.2022.09.023 · Cited by 184 · see citing works
Primary and transitional progressive MS
Stevenson, V. L., Miller, D. H., Rovaris, M., Barkhof, F., Brochet, B., Dousset, V., Dousset, V., Filippi, M., Montalbán, X., Polman, C. H., et al. (1999) · Neurology · doi:10.1212/wnl.52.4.839 · Cited by 177 · see citing works
Self-citationRETINAL PATHOLOGIC CHANGES IN MULTIPLE SCLEROSIS
Kerrison, J. B., FLYNN, T., & GREEN, W. R. (1994) · Retina · doi:10.1097/00006982-199414050-00010 · Cited by 173 · see citing works
Long-term remyelination after optic neuritis
Brusa, A., Jones, S. J., & Plant, G. T. (2001) · Brain · doi:10.1093/brain/124.3.468 · Cited by 165 · see citing works
Nolan‐Kenney, R. C., Liu, M., Akhand, O., Calabresi, P. A., Paul, F., Petzold, A., Balk, L., Brandt, A. U., Martínez‐Lapiscina, E. H., Saidha, S., et al. (2019) · Annals of Neurology · doi:10.1002/ana.25462 · Cited by 164 · see citing works
Self-citationLee, K. H., Hashimoto, S. A., Hooge, J. P., Kastrukoff, L. F., Oger, J. J.-F., Li, D. K. B., & Paty, D. W. (1991) · Neurology · doi:10.1212/wnl.41.5.657 · Cited by 163 · see citing works
Multimodal evoked potentials to assess the evolution of multiple sclerosis: a longitudinal study
Leocani, L. (2006) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2005.086280 · Cited by 160 · see citing works
Self-citationToussaïnt, D., Périer, O., Verstappen, A., et al. (1983) · PubMed · Cited by 122 · see citing works
Reproducibility of high-resolution optical coherence tomography in multiple sclerosis
Syc‐Mazurek, S. B., Warner, C. V., Hiremath, G. S., Farrell, S. K., Ratchford, J. N., Conger, A., Frohman, T. C., Cutter, G., Balcer, L. J., Frohman, E. M., et al. (2010) · Multiple Sclerosis Journal · doi:10.1177/1352458510371640 · Cited by 114 · see citing works
Self-citationBarkhof, F., Reich, D. S., Oh, J., Rocca, M. A., Li, D. K. B., Sati, P., Azevedo, C. J., Bagnato, F., Calabresi, P. A., Ciccarelli, O., et al. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00304-7 · Cited by 113 · see citing works
Self-citationChen, J. J., Sotirchos, E. S., Henderson, A. D., Vasileiou, E. S., Flanagan, E. P., Bhatti, M. T., Jamali, S., Eggenberger, E. R., Dinome, M., Frohman, L. P., et al. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.103525 · Cited by 102 · see citing works
Self-citationKim, K. H., Puoris’haag, M., Maguluri, G. N., et al. (2008) · Journal of Vision · doi:10.1167/8.1.17 · Cited by 100 · see citing works
Optical coherence tomography in multiple sclerosis: a 3-year prospective multicenter study
Paul, F., Calabresi, P. A., Barkhof, F., Green, A. J., Kardon, R., Sastre‐Garriga, J., Schippling, S., Vermersch, P., Saidha, S., Gerendas, B. S., et al. (2021) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51473 · Cited by 98 · see citing works
Self-citationSotirchos, E. S., Filippatou, A., Fitzgerald, K. C., Salama, S., Pardo, S., Wang, J., Ogbuokiri, E., Cowley, N. J., Pellegrini, N., Murphy, O. C., et al. (2020) · Multiple Sclerosis Journal · doi:10.1177/1352458519864928 · Cited by 98 · see citing works
Self-citationInternational Federation of Clinical Neurophysiology: Recommendations for visual system testing
Holder, G. E., Celesia, G. G., Miyake, Y., et al. (2010) · Clinical Neurophysiology · doi:10.1016/j.clinph.2010.04.010 · Cited by 94 · see citing works
Optical Coherence Tomography: An Introduction to the Technique and its Use
Hrynchak, P. K., & SIMPSON, T. L. (2000) · Optometry and Vision Science · doi:10.1002/j.1538-9235.2000.tb01115.x · Cited by 93 · see citing works
Vidal-Jordana, A., Rovira, A., Calderon, W., Arrambide, G., Castilló, J., Moncho, D., Rahnama, K., Collorone, S., Toosy, A. T., Ciccarelli, O., et al. (2024) · Neurology · doi:10.1212/wnl.0000000000207805 · Cited by 88 · see citing works
Beer, S., Rösler, K. M., & Hess, C. W. (1995) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.59.2.152 · Cited by 87 · see citing works
A NOTE ON TRANSNEURONAL ATROPHY IN THE HUMAN LATERAL GENICULATE BODY
Goldby, F. S. (1957) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.20.3.202 · Cited by 86 · see citing works
Hume, A. L., & Waxman, S. G. (1988) · Journal of the Neurological Sciences · doi:10.1016/0022-510x(88)90068-8 · Cited by 85 · see citing works
Serial Visual Evoked Potentials in 90 Untreated Patients With Acute Optic Neuritis
Frederiksen, J. L., & Petrera, J. (1999) · Survey of Ophthalmology · doi:10.1016/s0039-6257(99)00095-8 · Cited by 80 · see citing works
Visual Evoked Potentials as a Biomarker in Multiple Sclerosis and Associated Optic Neuritis
Leocani, L., Guerrieri, S., & Comı, G. (2018) · Journal of Neuro-Ophthalmology · doi:10.1097/wno.0000000000000704 · Cited by 70 · see citing works
Self-citationCordano, C., Sin, J. H., Timmons, G. M., Yiu, H., Stebbins, K. J., Guglielmetti, C., Cruz-Herranz, A., Xin, W., Lorrain, D. S., Chan, J. R., et al. (2022) · Brain · doi:10.1093/brain/awac207 · Cited by 67 · see citing works
Self-citationSensitivities and predictive values of paraclinical tests for diagnosing multiple sclerosis
Filippini, G., Comi, G. C., Cosi, V. E., et al. (1993) · Journal of Neurology · doi:10.1007/bf00868339 · Cited by 66 · see citing works
Jones, S. J. (1993) · Journal of Neurology · doi:10.1007/bf00874118 · Cited by 65 · see citing works
Retrograde and Wallerian Axonal Degeneration Occur Synchronously after Retinal Ganglion Cell Axotomy
Kanamori, A., Catrinescu, M., Bélisle, J. M., Costantino, S., & Levin, L. A. (2012) · American Journal Of Pathology · doi:10.1016/j.ajpath.2012.03.030 · Cited by 65 · see citing works
Optic Nerve Topography in Multiple Sclerosis Diagnosis
Vidal‐Jordana, Á., Rovira, À., Arrambide, G., et al. (2021) · Neurology · doi:10.1212/wnl.0000000000011339 · Cited by 64 · see citing works
Asymptomatic optic nerve lesions
Davion, J., Lopes, R., Drumez, É., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000009504 · Cited by 63 · see citing works
Self-citationEvoked potentials in the diagnosis of multiple sclerosis: a follow up study.
Matthews, W. B., Wattam-Bell, J., & Pountney, E. (1982) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.45.4.303 · Cited by 60 · see citing works
Bsteh, G., Hegen, H., Altmann, P., Auer, M., Berek, K., Di Pauli, F., Kornek, B., Krajnc, N., Leutmezer, F., Macher, S., et al. (2023) · Neurology · doi:10.1212/wnl.0000000000207507 · Cited by 59 · see citing works
Self-citationRetinal Asymmetry in Multiple Sclerosis
Petzold, A., Chua, S. Y. L., Khawaja, A. P., Keane, P. A., Khaw, P. T., Reisman, C., Dhillon, B., Strouthidis, N. G., Foster, P. J., Patel, P. J., et al. (2021) · Brain · doi:10.1093/brain/awaa361 · Cited by 56 · see citing works
Self-citationA Comprehensive Review on Methodologies Employed for Visual Evoked Potentials
Kothari, R., Bokariya, P., Singh, S., & Singh, R. (2016) · Scientifica · doi:10.1155/2016/9852194 · Cited by 54 · see citing works
Bsteh, G., Hegen, H., Altmann, P., et al. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102403 · Cited by 52 · see citing works
Self-citationOutteryck, O., Lopes, R., Drumez, É., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000009832 · Cited by 50 · see citing works
Self-citationSalehi, M. A., Nowroozi, A., Gouravani, M., Mohammadi, S., & Arevalo, J. F. (2022) · Survey of Ophthalmology · doi:10.1016/j.survophthal.2021.07.007 · Cited by 46 · see citing works
Davies, M. B., Williams, R., Haq, N., et al. (1998) · Neuroradiology · doi:10.1007/s002340050681 · Cited by 43 · see citing works
Retrograde trans-synaptic visual pathway degeneration in multiple sclerosis: A case series
Al-Louzi, O., Button, J., Newsome, S. D., Calabresi, P. A., & Saidha, S. (2017) · Multiple Sclerosis Journal · doi:10.1177/1352458516679035 · Cited by 40 · see citing works
Self-citationHigh test–retest reliability of checkerboard reversal visual evoked potentials (VEP) over 8 months
Sarnthein, J., Andersson, M., Zimmermann, M. B., & Zumsteg, D. (2009) · Clinical Neurophysiology · doi:10.1016/j.clinph.2009.08.014 · Cited by 38 · see citing works
Gabelić, T., Radmilović, M., Posavec, V., et al. (2012) · Acta Neurologica Belgica · doi:10.1007/s13760-012-0106-1 · Cited by 30 · see citing works
Cusato, K., Stagg, S. B., & Reese, B. E. (2001) · The Journal of Comparative Neurology · doi:10.1002/cne.1361 · Cited by 29 · see citing works
Multiple biomarkers improve the prediction of multiple sclerosis in clinically isolated syndromes
Martinelli, V., Dalla Costa, G., Messina, M. J., Di Maggio, G., Sangalli, F., Moiola, L., Rodegher, M., Colombo, B., Furlan, R., Leocani, L., et al. (2017) · Acta Neurologica Scandinavica · doi:10.1111/ane.12761 · Cited by 27 · see citing works
Self-citationShah, S. S., Morris, P., Buciuc, M., Tajfirouz, D., Wingerchuk, D. M., Weinshenker, B. G., Eggenberger, E. R., Di Nome, M., Pittock, S. J., Flanagan, E. P., et al. (2022) · Neurology · doi:10.1212/wnl.0000000000200838 · Cited by 26 · see citing works
Visual Evoked Potentials to Monitor Myelin Cuprizone-Induced Functional Changes
Marenna, S., Huang, S.-C., Dalla Costa, G., d’Isa, R., Castoldi, V., Rossi, E., Comi, G., & Leocani, L. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.820155 · Cited by 25 · see citing works
Self-citationBalcer, L. J., Balk, L. J., Brandt, A. U., Calabresi, P. A., Martinez-Lapiscina, E. H., Nolan, R. C., Paul, F., Petzold, A., Saidha, S., & on behalf of the IMSVISUAL Consortium (2018) · Journal of Neuro-Ophthalmology · doi:10.1097/wno.0000000000000732 · Cited by 25 · see citing works
Self-citationVEP and PERG in patients with multiple sclerosis, with and without a history of optic neuritis
Janáky, M., Jánossy, Á., Horváth, G., Benedek, G., & Braunitzer, G. (2017) · Documenta Ophthalmologica · doi:10.1007/s10633-017-9589-7 · Cited by 24 · see citing works
Distinguishing ischaemic optic neuropathy from optic neuritis by ganglion cell analysis
Erlich‐Malona, N., Mendoza‐Santiesteban, C. E., Hedges, T. R., Patel, N., Monaco, C., & Cole, E. (2016) · Acta Ophthalmologica · doi:10.1111/aos.13128 · Cited by 23 · see citing works
Trans‐Synaptic Degeneration Following Acute Optic Neuritis in Multiple Sclerosis
Murphy, O. C., Sotirchos, E. S., Kalaitzidis, G., et al. (2022) · Annals of Neurology · doi:10.1002/ana.26529 · Cited by 23 · see citing works
Self-citationContribution of the Degeneration of the Neuro-Axonal Unit to the Pathogenesis of Multiple Sclerosis
Salapa, H. E., Lee, S.-M., Shin, Y., & Levin, M. (2017) · Brain Science · doi:10.3390/brainsci7060069 · Cited by 22 · see citing works
Visual Pathway Measures are Associated with Neuropsychological Function in Multiple Sclerosis
Nguyen, J. V., Rothman, A., Fitzgerald, K. C., Whetstone, A., Syc‐Mazurek, S. B., Aquino, J. J., Balcer, L. J., Frohman, E. M., Frohman, T. C., Crainiceanu, C. M., et al. (2018) · Current Eye Research · doi:10.1080/02713683.2018.1459730 · Cited by 21 · see citing works
Self-citationCastoldi, V., Marenna, S., d’Isa, R., et al. (2019) · Brain Pathology · doi:10.1111/bpa.12762 · Cited by 21 · see citing works
Self-citationLin, T.-Y., Chien, C., Lu, A., Paul, F., & Zimmermann, H. G. (2021) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2021.1982697 · Cited by 16 · see citing works
Self-citationTranssynaptic Ganglion Cell Degeneration in Adult Patients After Occipital Lobe Stroke
Donaldson, L., Chen, M., & Margolin, E. (2022) · Journal of Neuro-Ophthalmology · doi:10.1097/wno.0000000000001657 · Cited by 15 · see citing works
MacIntosh, P. W. (2020) · International Journal of Ophthalmology · doi:10.18240/ijo.2020.01.17 · Cited by 13 · see citing works
Multiple sclerosis: incorporation of results of laboratory techniques in the diagnosis
Polman, C. H., Koetsier, J. C., & Wolters, E. C. (1985) · Clinical Neurology and Neurosurgery · doi:10.1016/0303-8467(85)90005-8 · Cited by 13 · see citing works
The use of OCT in good visual acuity MOGAD and AQP4-NMOSD patients; with and without optic neuritis
Roca-Fernández, A., Camera, V, Loncarevic-Whitaker, G., Messina, S., Mariano, R., Vincent, A., Sharma, S., Leite, M., & Palace, J. (2021) · Multiple Sclerosis Journal - Experimental, Translational and Clinical · doi:10.1177/20552173211066446 · Cited by 12 · see citing works
Lin, T.-Y., Motamedi, S., Asseyer, S., Chien, C., Saidha, S., Calabresi, P. A., Fitzgerald, K. C., Samadzadeh, S., Villoslada, P., Llufriu, S., et al. (2024) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000200269 · Cited by 12 · see citing works
Self-citationTrans-synaptic degeneration as a mechanism of neurodegeneration in multiple sclerosis
Murphy, O. C., Calabresi, P. A., & Saidha, S. (2023) · Neural Regeneration Research · doi:10.4103/1673-5374.373661 · Cited by 11 · see citing works
Self-citationTajfirouz, D., Madhavan, A., Pacheco Marrero, J. M., Krecke, K. N., Fautsch, K. J., Flanagan, E. P., Pittock, S. J., Shah, S., Bhatti, M. T., & Chen, J. J. (2024) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000200277 · Cited by 11 · see citing works
Application of the international criteria for optic neuritis in the Acute Optic Neuritis Network
Klyscz, P., Asseyer, S., Alonso, R. N., et al. (2024) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.52166 · Cited by 11 · see citing works
Self-citationAmezcua, L., Robers, M., Soneji, D. J., et al. (2023) · Multiple Sclerosis Journal · doi:10.1177/13524585231209016 · Cited by 10 · see citing works
Wang, X., Chen, Y., Wang, Z., Li, H., He, Q., Rong, H., & Wei, R. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.918393 · Cited by 7 · see citing works
Retinal changes in double-antibody seronegative neuromyelitis optica spectrum disorders
Oertel, F. C., Zimmermann, H. G., Motamedi, S., Bereuter, C., Manthey, L. M., Ashtari, F., Kafieh, R., Dehghani, A., Pourazizi, M., Pandit, L., et al. (2024) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000200273 · Cited by 6 · see citing works
Self-citationDuvigneaud, Z., Lardeux, P., Verrecchia, S., Benyahya, L., Marignier, R., & Tilikete, C. (2024) · Journal of Neurology · doi:10.1007/s00415-024-12540-9 · Cited by 6 · see citing works
Functional connectivity alterations in a murine model of optic neuritis
Wright, P. W., Archambault, A. S., Peek, S. L., Bauer, A. Q., Culican, S. M., Ances, B. M., Culver, J. P., & Wu, G. F. (2017) · Experimental Neurology · doi:10.1016/j.expneurol.2017.05.004 · Cited by 4 · see citing works
Application of diagnostic criteria for optic neuritis – Authors' reply
Petzold, A., Liu, Y., Fraser, C. L., et al. (2023) · The Lancet Neurology · doi:10.1016/s1474-4422(23)00110-2 · Cited by 3 · see citing works
Self-citationSaidha, S., Sotirchos, E. S., Oh, J., et al. (2012) · JAMA Neurology · doi:10.1001/archneurol.2013.573
Self-citationReply: Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography
Saidha, S., Syc, S. B., Frohman, E. M., et al. (2011) · Brain · doi:10.1093/brain/awr096
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Behbehani, 2007, Clinical approach to optic neuropathies, Clin Ophthalmol, 1, 233
Cited by
Sorted by citations
Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria
Montalban, X., Lebrun-Frénay, C., Oh, J., Arrambide, G., Moccia, M., Pia Amato, M., Amezcua, L., Banwell, B., Bar-Or, A., Barkhof, F., et al. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00270-4 · Cited by 551 · see citing works
Self-citationBarkhof, F., Reich, D. S., Oh, J., Rocca, M. A., Li, D. K. B., Sati, P., Azevedo, C. J., Bagnato, F., Calabresi, P. A., Ciccarelli, O., et al. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00304-7 · Cited by 113 · see citing works
Self-citationBrownlee, W. J., Maccarrone, D., Nistri, R., Yam, C., Wilson, H., Wright, S., Mankad, K., Hemingway, C., Thompson, A. J., Hacohen, Y., et al. (2026) · Neurology · doi:10.1212/wnl.0000000000214688 · Cited by 17 · see citing works
Self-citationBsteh, G., Escola, L. V., Hegen, H., Lindner, E., Khalil, M., Schneider, S., Traxler, G., Raithel, E., Bsteh, C., Mitsch, C., et al. (2025) · Journal of Neurology · doi:10.1007/s00415-025-13537-8 · Cited by 7 · see citing works
Self-citationLafontaine, J.-C., Bordier, C., Labreuche, J., et al. (2026) · Brain Communications · doi:10.1093/braincomms/fcag020 · Cited by 4 · see citing works
“Finally, we assessed the concordance between IETD criteria (pRNFL-IETD ≥ 6 µm/GCIPL-IETD ≥ 4 µm) 27 and MRI diagnostic of optic nerve lesion by calculating the Cohen’s κ coefficients with theirs 95% CIs.”
Self-citationPerformance of the 2024 McDonald diagnostic criteria for multiple sclerosis
Abad-Inchaurrondo, I., Lu, S., Lui, E., et al. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585261421816 · Cited by 4 · see citing works
Global Access to Diagnostic Paraclinical Testing Incorporated in the 2024 Revised McDonald Criteria
Solomon, A. J., Zakaria, M. F., Saylor, D. R., Viswanathan, S., Czarnota-Szałkowska, D., Banwell, B., Coetzee, T., Montalbán, X., Hillman, N., Shinohara, R. T., et al. (2026) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000200633 · Cited by 3 · see citing works
Self-citation2024 Diagnostic Criteria for Multiple Sclerosis—A Unified Approach
Toljan, K., Oh, J., & Ontaneda, D. (2025) · JAMA Neurology · doi:10.1001/jamaneurol.2025.4243 · Cited by 2 · see citing works
GFAP, CHI3L1 and GCIPL Thickness as Baseline Predictors of Early Disability Progression in MS
Enache, I. I., Tiu, V. E., Anghel, C. A., Tiu, C., Popa‐Cherecheanu, A., Bostan, M., Scippa, S., Balestrieri, A., Smaldone, G., & Soricelli, A. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262411774 · Cited by 2 · see citing works
“GCIPL thickness has been found to have superior reliability and reproducibility compared to RNFL thickness, proving superior correlation with both visual function and global disability scores [15].”
Alchaki, A. R. (2026) · Neurologic Clinics · doi:10.1016/j.ncl.2025.12.003 · Cited by 2 · see citing works
Khodabandeh, Z., Rabbani, H., Bidabadi, N. S., Ashtari, F., STEEL, D. H., Bacardit, J., Hurlbert, A. C., & Kafieh, R. (2026) · Experimental Eye Research · doi:10.1016/j.exer.2026.110916 · Cited by 2 · see citing works
Jia, F., & Ng, K. (2026) · BMJ Neurology Open · doi:10.1136/bmjno-2025-001422 · Cited by 1 · see citing works
Delikaya, M., Hamdi, R., Bereuter, C., Schroeter, J., & Oertel, F. C. (2026) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2026.2632795 · Cited by 2 · see citing works
Bacchetti, A., McCormack, B., Lin, T., Filippatou, A. G., Gakis, G., Pellegrini, N., Kinder, E., Gulati, A., Lievers, E., Otero-Duran, G., et al. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585261426768 · Cited by 1 · see citing works
Self-citationGreco, G., Rigoni, E., Masi, F., et al. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585261424125 · Cited by 1 · see citing works
Contribution of new imaging sequences to the diagnosis of multiple sclerosis
Moccia, M., & Cocozza, S. (2026) · Revue Neurologique · doi:10.1016/j.neurol.2025.12.011 · Cited by 1 · see citing works
Horebeek, L. V., Das, A., Neufeld, J., & Schneider, R. (2026) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-026-01495-1 · Cited by 1 · see citing works
Montalbán, X., Oh, J., Coetzee, T., & Thompson, A. J. (2026) · The Lancet Neurology · doi:10.1016/s1474-4422(26)00170-5 · Cited by 1 · see citing works
Self-citationKrajnc, N., Bertich, M., Föttinger, F., Macher, S., Schwarz, F. K., Stapf, C., Pemp, B., & Bsteh, G. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15113999 · Cited by 1 · see citing works
“Eyes with a history of ON occurring ≥ 6 months before baseline, as well as eyes without documented ON but exhibiting inter-eye differences suggestive of prior asymptomatic optic nerve involvement, defined as a ≥ 4 µ m difference in GCIPL thickness, were eligible for inclusion [22].”
Self-citationChen, Z., Zhang, B., Zhang, C., et al. (2026) · Land · doi:10.3390/land15061042 · Cited by 1 · see citing works
Konen, F. F., Mahmoudi, N., Albers, L. M., Arrambide, G., Streichert, A. L., Haar, M., Soldatov, A., Bucak, E., Jendretzky, K. F., Nay, S., et al. (2026) · eClinicalMedicine · doi:10.1016/j.eclinm.2026.104098
Self-citationShedding new light on the diagnosis of multiple sclerosis
Galetta, S. L., & Bennett, J. L. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00310-2
Seferoğlu, M., Ayar, K., & Yener, N. P. (2025) · Research Square · doi:10.21203/rs.3.rs-8139231/v1
Mitsoudis, N., Nikolakakis, I., Giantzi, V., Pirounides, D., & Bakirtzis, C. (2025) · Cureus · doi:10.7759/cureus.97579
“These metrics, used in Case 2, can differentiate healthy controls from people with MS and quantify neurodegeneration [7].”
Delikaya, M., Bereuter, C., Schroeter, J., et al. (2025) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/20552173251397772
“…the 2024 McDonald criteria for MS emphasizes the increasing signi fi cance of objectively detecting optic nerve involvement during neurological assessments in pwMS. 12,13 However, the structure of access to diagnostic procedures that can reliably objectify such involvement has not been investigated.”
Self-citationMcDonald criteria, a standard for diagnosing multiple sclerosis – past and present
Mycko, M. P. (2025) · Aktualności Neurologiczne · doi:10.15557/an.2025.0016 · Cited by 1 · see citing works
Tri-modal assessment reveals early visual pathway degeneration in patients with MSA-C
Wang, C., Deng, F., Chen, Z., Chen, D., Wan, L., Long, Z., Ouyang, R., Wu, Q., Long, Q., He, J., et al. (2025) · Neurobiology of Disease · doi:10.1016/j.nbd.2025.107243
Optic nerve assessments in MS diagnosis are worth the added implementation complexity: No
Ciampi, E., Soler, B., & Garcia, L. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585251410416
Optic nerve assessments in MS diagnosis are worth the added implementation complexity: Yes
Bsteh, G., & Krajnc, N. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585251410417
Self-citationOptic nerve assessments in MS diagnosis are worth the added implementation complexity: Commentary
Yeh, E. A. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585251410415
Guido, F. S., Chen, J. J., Decker, P. A., et al. (2026) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2026.125821
Kana, V., Herwerth, M., Gugleta, K., et al. (2026) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/20552173261419951
“2 Regarding the use of OCT in patients with acute ON (reported by 44% of the participants in our survey), it should be noted that the timing of the examination is highly relevant, as OCT sensitivity increases in the sub-acute and chronic phase after ON, as retrograde degeneration leading to pRNFL…”
Steffen, H. (2026) · Klinische Monatsblätter für Augenheilkunde · doi:10.1055/a-2685-3349
Updates on Pediatric Optic Neuritis
Cegielski, V., Shinbashi, M. Y., & Paton, G. R. (2026) · International Ophthalmology Clinics · doi:10.1097/iio.0000000000000605
Filippatou, A. G., Gakis, G., Bacchetti, A., et al. (2026) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000200567
“23,24 Notably, the GCL/ GCIPL ratio was also reduced in MS non-ON eyes compared with HC, and in some MS non-ON eyes, it was lower than in their fellow ON eyes.”
Self-citationUpdates in Treatment of Optic Neuritis
Towairqi, W. A., Rush, C., Torres, C., & Karanjia, R. (2026) · Advances in Ophthalmology and Optometry · doi:10.1016/j.yaoo.2026.02.005
Evolving MS diagnostic criteria: Progress and challenges
Lebrun‐Frénay, C. (2026) · Revue Neurologique · doi:10.1016/j.neurol.2025.12.010
Diagnosis of Multiple Sclerosis
Arrambide, G., & Lebrun‐Frénay, C. (2026) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/cont.0000000000001696
Güleç, B., Everest, E., Tütüncü, M., et al. (2026) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.70389
Steffen, H. (2026) · Augenheilkunde up2date · doi:10.1055/a-2818-0709
McDonald-Kriterien 2024 ermöglichen frühere Diagnose der Multiplen Sklerose
Menge, T. (2026) · InFo Neurologie + Psychiatrie · doi:10.1007/s15005-026-4709-0
Inner Plexiform Layer Microstructure Is Altered in Multiple Sclerosis
Emfietzoglou, M., Correa, V., Sakuno, G., et al. (2026) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.67.6.3
“4 When alternative causes are excluded and image quality is adequate, intereye asymmetry in peripapillary retinal nerve fiber layer (RNFL) thickness ( ≥ 6 μm) or macular ganglion cell–inner plexiform layer (GCIPL) thickness ( ≥ 4 μm) can provide supportive evidence of optic nerve involvement.”
Optic nerve involvement in multiple sclerosis diagnosis – Authors’ reply
Saidha, S., Green, A., Balcer, L. J., et al. (2026) · The Lancet Neurology · doi:10.1016/s1474-4422(26)00203-6
Self-citationOptic nerve involvement in multiple sclerosis diagnosis
Luo, W., Wei, Z., Huang, X., et al. (2026) · The Lancet Neurology · doi:10.1016/s1474-4422(26)00202-4
Zhu, Y., Li, M., Wang, Z., & Gu, X. (2026) · Neurobiology of Disease · doi:10.1016/j.nbd.2026.107511
Epiretinal membranes in multiple sclerosis: A window into glial pathobiology?
Syc‐Mazurek, S. B., & Chen, J. J.-W. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585261464504
Case Report: Multiple sclerosis and Neurofibromatosis type 1: a rare comorbidity
Musci, A., Bonan, L., Manzoni, E., et al. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1870007
“While studies have demonstrated reduced average RNFL thickness in MS patients without optic neuritis due to chronic degeneration (14), it is noteworthy that a case of bilateral optic atrophy has also been described in an NF1 patient without evidence of OPGs (17).”
Immune-mediated optic neuritis: A historical perspective
Inzunza, A., Flanagan, E. P., & Chen, J. J.-W. (2026) · Survey of Ophthalmology · doi:10.1016/j.survophthal.2026.07.002
Syc‐Mazurek, S. B., Liskey, D., Tajfirouz, D. A., et al. (2026) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2026.107399
Thompson, A. J., LUBLIN, F. D., Rechtman, L., Quinn, J., Amato, M. P., Bebo, B. F., Calabresi, P. A., Fiol, J., Finlayson, M. L., Hawton, A., et al. (2026) · Nature Reviews Neurology · doi:10.1038/s41582-026-01249-0
“These landmarks are illustrative to convey the concepts and range of possibilities, but further work is needed to define an operationalized set of assessment markers.”
Self-citationZheng, L., Deng, Y., Huang, Z., et al. (2026) · Sensors · doi:10.3390/s26154982
“Optical coherence tomography (OCT) has revolutionized ophthalmic diagnostics by providing real-time, non-invasive, high-resolution cross-sectional imaging of ocular structures [1–4].”
Application of the 2024 McDonald Criteria
Solomon, A. J., Brownlee, W. J., Viswanathan, S., Fadda, G., Fiol, J., Galleguillos, L., Griffin, T., Sahraian, M. A., Saylor, D. R., Rovira, À., et al. (2026) · Neurology · doi:10.1212/wnl.0000000000218425
“7 Several tools are available for evaluating the optic nerve for objective evidence of a lesion as detailed in a recent review, 22 including (1) orbital MRI demonstrating a T2-hyperintense optic nerve lesion, (2) abnormal visual evoked potentials ( ) with prolonged P100 latency, and (3) optical…”
Domínguez-Vargas, C., García-Hernández, J. E., Peña-Durán, E., Prado-López, P. M., Ramírez-Flores, S. J., Pérez-Castellón, M. C., Márquez-González, D. J., Robles-Loera, D. M., Aceves-Castillo, D. H., Martínez-Hernández, R. E., et al. (2026) · doi:10.3390/msf2026046010
“Additionally, neurophysiological studies, including evoked potentials, provide functional evidence of subclinical demyelination and may contribute to early diagnosis and prognosis [10].”
Modern diagnosis and treatment of multiple sclerosis: advances, challenges, and future directions
Siriratnam, P., Datta, M., Buzzard, K. A., Wesselingh, R., Yeh, W., Seery, N., Zhong, M., He, A. H., Jokubaitis, V., Wijeratne, T., et al. (2026) · Autoimmunity Reviews · doi:10.1016/j.autrev.2026.104169
Хабиров, Ф. А., Granatov, E. V., Хайбуллин, Т. И., & Dykhanov, A. Y. (2026) · Neurology Bulletin · doi:10.17816/nb703764
Pediatric multiple sclerosis: a diagnostic overview and the importance of early identification
Margoni, M., Filippi, M., & Rocca, M. A. (2026) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2026.2726418
Bollo, L., Vidal‐Jordana, Á., Rodrı́guez‐Acevedo, B., et al. (2026) · Journal of Neurology · doi:10.1007/s00415-026-13972-1
“Another compelling argument for including VEPs in the diagnostic workup of optic neuritis stems from their formal reintroduction in the 2024 McDonald criteria for multiple sclerosis [13, 21, 24] where they are recognized as supportive evidence of optic nerve involvement.”
Barbuti, E., Borrelli, S., Guisset, F., London, F., Sankari, S. E., Conte, A., Lommers, É., Pesch, V. V., & Maggi, P. (2026) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2026-339497
Öncel, S., Seferoğlu, M., Ömerhoca, S., Aksu, S., Çınar, E., Kılıçaslan, H., Tunç, A., & İçen, N. K. (2026) · Medicina · doi:10.3390/medicina62091750
“The reaffirmed diagnostic role of VEP within the 2024 revised McDonald criteria further underscores the value of standardized, serial optic pathway assessment in contemporary MS care [12].”
Real-world applicability of the 2024 McDonald criteria for multiple sclerosis diagnosis in Portugal
Teixeira, C. L., Soares, M., & Guimarães, J. (2026) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2026.107926
Aghababaei, A., Etemadifar, M., Atapour-Abarghouei, A., Innes, W., Fard, M., Paul, F., Rabbani, H., & Kafieh, R. (2026) · Annual Review of Vision Science · doi:10.1146/annurev-vision-110423-025837
Self-citationBerek, K., Schmidauer, M., Föttinger, F., Auer, M., Berger, T., Pauli, F. D., Escolà, L. V., Hofer, T., Kremser, B., Mangesius, S., et al. (2026) · European Journal of Neurology · doi:10.1111/ene.70759
“…present study, we evaluated the relationship between two biomarkers recently introduced in the diagnostic criteria of patients with suspected MS, namely κ-FLC index, reflecting intrathecal plasma cell activity [18], and retinal layer thickness measured by OCT, reflecting neuroaxonal damage [19].”
Self-citationVEP latency delays predicts MRI neurodegenerative outcomes in multiple sclerosis
Jakimovski, D., Weller, J., Zivadinov, R., Weinstock-Guttman, B., Golan, D., Zarif, M., Costello, F., Sergott, R. C., Galetta, S. L., Kenney, R., et al. (2026) · Journal of Neurology · doi:10.1007/s00415-026-14151-y
“Based on these observations, OCT measures have been implemented in the most recent 2024-revision of McDonald MS diagnostic criteria [6].”
InfluentialSelf-citationSchoenholzer, K., Sellathurai, S., Villena, F. B., et al. (2026) · Multiple Sclerosis Journal · doi:10.1177/13524585261489425
“19 Moreover, in accordance with the OSCAR-IB criteria, 16 we excluded eyes with relevant ocular pathology on OCT from the entire analysis (Figure 2).”
Вітовська, О. П., & Sarhosh, V. V. (2026) · Archive of Ukrainian Ophthalmology · doi:10.22141/2309-8147.14.2.2026.455
Capobianco, M., Zeppieri, M., Nicolosi, S. G., et al. (2026) · Vision · doi:10.3390/vision10040078
- Authors
- Saidha, S., Green, A. J., Leocani, L., Vidal-Jordana, A., Kenney, R. C., Bsteh, G., Outteryck, O., Thompson, A., Montalban, X., Coetzee, T., Petzold, A., Paul, F., Balcer, L. J., & Calabresi, P. A.
- Affiliations
- Johns Hopkins University (US)
- University of California, San Francisco (US)
- Vita-Salute San Raffaele University (IT)
- New York University (US)
- Medical University of Vienna (AT)
- Université de Lille (FR)
- National Hospital for Neurology and Neurosurgery (GB)
- National Multiple Sclerosis Society (US)
- Moorfields Eye Hospital (GB)
- Max Delbrück Center (DE)
- Corresponding author
- Saidha, Shiv
- Calabresi, Peter A
- ORCID
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2025-10
- Volume
- 24
- Issue
- 10
- Pages
- 880-892
- ISSN
- 1474-4422 (ISSN-L)
- OpenAlex
- W4414272664
- Semantic Scholar
- 491c581849326ffe5767abd9c041b8051a024665
- Cited by
- 66
- References
- 96
- Citations by year
- 2026: 55 · 2025: 11
- FWCI
- 37.74
- Type
- journal article
- Language
- en
- Update notices
- erratum (2025-11-01)
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- European Committee for Treatment and Research in Multiple Sclerosis
- National Multiple Sclerosis Society
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Ophthalmology › Retinal and Optic Conditions
- Keywords
- multiple sclerosis, optic nerve lesions, optical coherence tomography, visual evoked potentials, peripapillary retinal nerve fiber layer, demyelination, optic nerve injury, dissemination in space, diagnostic criteria
- MeSH terms
- Evoked Potentials, Visual, Humans, Multiple Sclerosis, Optic Nerve, Tomography, Optical Coherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-23.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-23.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
