Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test
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Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test. / Pihl-Jensen, Gorm; Ivanov, Iliya; Hinze, Desiree; Trauzettel-Klosinski, Susanne; Frederiksen, Jette Lautrup.
I: Ophthalmic Research, Bind 63, Nr. 3, 2020, s. 332-340.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test
AU - Pihl-Jensen, Gorm
AU - Ivanov, Iliya
AU - Hinze, Desiree
AU - Trauzettel-Klosinski, Susanne
AU - Frederiksen, Jette Lautrup
N1 - © 2019 S. Karger AG, Basel.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: The Aulhorn flicker test (AFT) previously showed promise in diagnosing acute optic neuritis (ON) albeit with suboptimal sensitivity. A new, digitalized version of the AFT (the DFT) has not previously been examined in acute ON.OBJECTIVES: To examine the sensitivity, specificity and reproducibility of the DFT in acute ON.METHOD: The DFT assesses the subjective brightness of a flickering field (1-60 Hz). In normal subjects, brightness enhancement occurs at intermediate frequencies, whereas in acute ON darkness enhancement (DE) is hypothesized. AFT and DFT measurements were obtained in acute ON patients (≤31 days from first symptom) with DE as a quantitative covariate. Reproducibility of the DFT end point was assessed in the form of an intraclass correlation.RESULTS: 30 untreated first-time acute ON patients and 55 healthy controls were examined. AFT and DFT were performed 12.7 days (range: 4-30) following ON onset. The DFT showed a sensitivity of 0.93 (95% CI = 0.78-0.99) to a specificity of 0.96 (95% CI = 0.87-1.00). The AFT showed a sensitivity of 0.76 (95% CI = 0.56-0.90) to a specificity of 1.00 (95% CI = 0.93-1.00). No significant correlation was shown between DFT and visual acuity. The intraclass correlation of the DFT end point in healthy subjects was 0.84.CONCLUSIONS: We present a new DFT in acute ON displaying a high specificity of 0.96 and a sensitivity of 0.93. Our study indicates the DFT to be an accurate and easy-to-use tool in diagnosing acute ON, which may be especially helpful in atypical cases.
AB - BACKGROUND: The Aulhorn flicker test (AFT) previously showed promise in diagnosing acute optic neuritis (ON) albeit with suboptimal sensitivity. A new, digitalized version of the AFT (the DFT) has not previously been examined in acute ON.OBJECTIVES: To examine the sensitivity, specificity and reproducibility of the DFT in acute ON.METHOD: The DFT assesses the subjective brightness of a flickering field (1-60 Hz). In normal subjects, brightness enhancement occurs at intermediate frequencies, whereas in acute ON darkness enhancement (DE) is hypothesized. AFT and DFT measurements were obtained in acute ON patients (≤31 days from first symptom) with DE as a quantitative covariate. Reproducibility of the DFT end point was assessed in the form of an intraclass correlation.RESULTS: 30 untreated first-time acute ON patients and 55 healthy controls were examined. AFT and DFT were performed 12.7 days (range: 4-30) following ON onset. The DFT showed a sensitivity of 0.93 (95% CI = 0.78-0.99) to a specificity of 0.96 (95% CI = 0.87-1.00). The AFT showed a sensitivity of 0.76 (95% CI = 0.56-0.90) to a specificity of 1.00 (95% CI = 0.93-1.00). No significant correlation was shown between DFT and visual acuity. The intraclass correlation of the DFT end point in healthy subjects was 0.84.CONCLUSIONS: We present a new DFT in acute ON displaying a high specificity of 0.96 and a sensitivity of 0.93. Our study indicates the DFT to be an accurate and easy-to-use tool in diagnosing acute ON, which may be especially helpful in atypical cases.
U2 - 10.1159/000503304
DO - 10.1159/000503304
M3 - Journal article
C2 - 31655815
VL - 63
SP - 332
EP - 340
JO - Ophthalmic Research
JF - Ophthalmic Research
SN - 0030-3747
IS - 3
ER -
ID: 256572993