Beck and Cleary1 reported no effect of corticosteroid therapy on visual outcome 1 year following an acute attack of optic neuritis. The Optic Neuritis Treatment Trial (ONTT) appears to have been a wellrun therapeutic trial and should serve as a good model for other multicenter trials to evaluate therapeutic intervention for optic neuropathy. I wonder whether the inclusion of pattern visual evoked potentials (PVEPs) in this study would have provided additional useful information regarding effects of corticosteroid treatment. Latency of the P100 component of the PVEP remains abnormally prolonged in approximately 90% of patients following optic neuritis, despite recovery of visual function to normal levels.2 Halliday and McDonald3 propose that the abnormal PVEP latency represents conduction delays caused by demyelination in functioning optic nerve fibers, whereas loss of visual function is caused by conduction block. Thus, PVEP latency can provide a measure of therapeutic effect on the
Brigell M. Pattern Visual Evoked Potentials in Treatment Trials for Optic Neuropathy. Arch Ophthalmol. 1994;112(3):299–300. doi:10.1001/archopht.1994.01090150029006
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