The Aulhorn flicker test: possibilities and limits. Its use in optic neuritis for diagnosis, differential diagnosis, monitoring the course of the disease, and assessing the effect of oral prednisolone.

The Aulhorn flicker test, which measures subjective brightness in relation to flicker frequency, is of high specificity (98%) and sensitivity (85.5%) in active optic neuritis (ON). The test has proved to be valuable in the diagnosis and differential diagnosis of ON and in monitoring the course of the disease. The first part of this paper gives an overview based on more than 10 years of experience and on the evaluation of more than 1000 eyes, 250 of them with active ON. The possibilities and limits of the test are analyzed. The second part of the paper presents new results of a prospective, randomized, and controlled treatment study. The Aulhorn flicker test was used to determine whether a prednisolone effect would be assessable by means of this subtle parameter. A total of 50 patients were treated orally with either methylprednisolone (100 mg/day initially) or vitamin B1 (100 mg/day), 38 of them in a double-blind fashion. Although a trend toward faster recovery in favor of prednisolone treatment was noted, no long-term benefit was observed after 1 year.