Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Ophthalmology
Published in: International Ophthalmology 3/2018

01-06-2018 | Original Paper

Critical flicker fusion frequency in demyelinating and ischemic optic neuropathies

Authors: Matthew T. Young, Puneet S. Braich, Scott R. Haines

Published in: International Ophthalmology | Issue 3/2018

Login to get access

Abstract

Purpose

Critical flicker fusion (CFF) frequency is a well-studied test for evaluating demyelinating optic neuritis (ON). Its use in evaluating other optic neuropathies is not well established. The purpose of this study was to compare CFF in ON and non-arteritic anterior ischemic optic neuropathy (NAION).

Methods

We performed a retrospective review to compare multiple variables for eyes with ON or NAION using two-sided T tests and Chi-square tests. A multivariate linear regression was performed for the dependent variable CFF. A receiver operating characteristic (ROC) curve was used to define a CFF threshold for distinguishing these entities.

Results

Unaffected eyes had an average CFF value of 31.5 Hz. CFF values for ON (20.7 Hz ± 7.36) and NAION (24.3 Hz ± 9.03) were not significantly different from each other (P = 0.06). However, the CFF for ON, 18.27 Hz ± 9.29, was significantly lower than for NAION, 23.92 Hz ± 7.02, P = 0.02 when limiting the comparison to moderate and severe disease. An ROC curve demonstrates that a CFF value of ≤24 Hz is 71% sensitive for ON and that a value >24 Hz is 74% specific for excluding ON. A multivariate linear regression model demonstrated that ON contributed to approximately an 8 Hz decrease in CFF compared to NAION. Patients with a CFF of ≤24 Hz have a 2.89 odds ratio (95% CI 1.76–4.01) of having ON.

Conclusion

CFF values in eyes with ON were significantly lower compared to eyes with NAION when evaluating moderate and severe disease. Twenty-four hertz may be a useful CFF threshold value when trying to distinguish between these two entities.
Literature
1.
Brenton RS, Thompson HS, Maxner, C, Critical flicker frequency: a new look at an old test. In: New methods of sensory visual testing 1989 Springer, pp 29–52
2.
Daley ML, Swank RL, Ellison CM (1979) Flicker fusion thresholds in multiple sclerosis. A functional measure of neurological damage. Arch Neurol 36(5):292–295CrossRefPubMed
3.
Miller PN, Parsons OA (1957) Flicker fusion thresholds in multiple sclerosis. AMA Arch Neurol Psychiatry 77(2):134–139CrossRefPubMed
4.
5.
Jacobson DM, Olson KA (1991) Impaired critical flicker frequency in recovered optic neuritis. Ann Neurol 30(2):213–215CrossRefPubMed
6.
Raz N, Shear-Yashuv G, Backner Y, Bick AS, Levin N (2015) Temporal aspects of visual perception in demyelinative diseases. J Neurol Sci 357(1–2):235–239CrossRefPubMed
7.
Haines SR, Longmuir RA (2014) Optic neuropathy due to biotinidase deficiency in a 19-year-old man. JAMA Ophthalmol 132(2):228–230CrossRefPubMed
8.
Kang H, Takahashi Y, Nishimura K, Yasuda M, Akutsu H, Kakizaki H (2016) Improved vision from severe compressive optic neuropathy by apical cavernous hemangioma. Case Rep Ophthalmol 7(1):179–183CrossRefPubMedPubMedCentral
9.
Takahashi Y, Kakizaki H (2015) Orbital decompression for compressive optic neuropathy in patients with a metastatic orbital tumor from breast carcinoma. Orbit 34(3):137–141CrossRefPubMed
10.
11.
Hartmann E, Lachenmayr B, Brettel H (1979) The peripheral critical flicker frequency. Vision Res 19(9):1019–1023CrossRefPubMed
12.
Johnson LN, Arnold AC (1994) Incidence of nonarteritic and arteritic anterior ischemic optic neuropathy. Population-based study in the state of Missouri and Los Angeles County, California. J Neuroophthalmol 14(1):38–44CrossRefPubMed
13.
Misiak H (1947) Age and sex differences in critical flicker frequency. J Exp Psychol 37(4):318–332CrossRefPubMed
14.
Mewborn C, Renzi LM, Hammond BR, Miller LS (2015) Critical flicker fusion predicts executive function in younger and older adults. Arch Clin Neuropsychol 30(7):605–610CrossRefPubMed
15.
Morgan MY, Amodio P, Cook NA, Jackson CD, Kircheis G, Lauridsen MM, Montagnese S, Schiff S, Weissenborn K (2016) Qualifying and quantifying minimal hepatic encephalopathy. Metab Brain Dis 31(6):1217–1229CrossRefPubMed
16.
Khade A, Bashir MS, Kale AS, Turankar A (2010) Study of the effect of nortriptyline and fluvoxamine on psychomotor functions in healthy volunteers. Indian J Psychol Med 32(2):104–107CrossRefPubMedPubMedCentral
Metadata
Title
Critical flicker fusion frequency in demyelinating and ischemic optic neuropathies
Authors
Matthew T. Young
Puneet S. Braich
Scott R. Haines
Publication date
01-06-2018
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 3/2018
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-017-0561-z

Other articles of this Issue 3/2018

International Ophthalmology 3/2018 Go to the issue

Original Paper

Self-made cryopreservative fibrin glue applied in pterygium surgery: a novel practical technique

Original Paper

The overlapping spectrum of flat irregular pigment epithelial detachment investigated by optical coherence tomography angiography

Original Paper

Treatment of patients with neurotrophic keratitis stages 2 and 3 with plasma rich in growth factors (PRGF-Endoret) eye-drops

Original Paper

Impact of estimated glomerular filtration rate on diabetic macular edema

Original Paper

The clinical characteristics and prognosis of acute zonal occult outer retinopathy

Original Paper

Fine mapping of chromosome 9 locus associated with congenital cataract