Dataset Information

Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography.

ABSTRACT:

Purpose

To evaluate the thickness of the inner retinal layers in the macula using frequency-domain optical coherence tomography (fd-OCT) in patients with demyelinating diseases.

Design

Cross-sectional study.

Participants

A total of 301 eyes of 176 subjects were evaluated. Subjects were divided in 5 different groups: controls, neuromyelitis optica (NMO), longitudinally extensive transverse myelitis (LETM), multiple sclerosis with a history of optic neuritis (MS-ON), and multiple sclerosis without a history of optic neuritis (MS non-ON).

Methods

The individual layers from macular fd-OCT cube scans were segmented with an automated algorithm and then manually hand-corrected. For each scan, we determined the thickness of the retinal nerve fiber layer (RNFL), the combined retinal ganglion cell and inner plexiform layers (RGCL+), and the inner nuclear layer (INL).

Main outcome measures

Macular RNFL, RGCL+, and INL thickness.

Results

The RNFL was significantly thinner than in controls for all patient groups (P ? 0.01). Macular RGCL+ thickness was significantly thinner than in controls for the NMO, MS-ON, and MS non-ON groups (P<0.001 for the 3 groups). The INL thickness was significantly thicker than in controls for the patients with NMO (P = 0.003) and LETM (P = 0.006) but not for those with MS-ON or MS non-ON. Although the RNFL and RGCL+ were not significantly different between the NMO and MS-ON groups, the patients with NMO had a significantly thicker INL than the patients with MS-ON (P = 0.02).

Conclusions

Macular RNFL and RGCL+ demonstrate axonal and neural loss in patients with MS, either with or without ON, and in patients with NMO. In addition, the INL thickening occurs in patients with NMO and patients with LETM, and study of this layer may hold promise for differentiating between NMO and MS.

SUBMITTER: Fernandes DB

PROVIDER: S-EPMC3554837 | biostudies-literature | 2013 Feb

REPOSITORIES: biostudies-literature

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Publications

Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography.

Fernandes Danilo B DB Raza Ali S AS Nogueira Rafael G F RG Wang Diane D Callegaro Dagoberto D Hood Donald C DC Monteiro Mario L R ML

Ophthalmology 20121018 2

<h4>Purpose</h4>To evaluate the thickness of the inner retinal layers in the macula using frequency-domain optical coherence tomography (fd-OCT) in patients with demyelinating diseases.<h4>Design</h4>Cross-sectional study.<h4>Participants</h4>A total of 301 eyes of 176 subjects were evaluated. Subjects were divided in 5 different groups: controls, neuromyelitis optica (NMO), longitudinally extensive transverse myelitis (LETM), multiple sclerosis with a history of optic neuritis (MS-ON), and mult ...[more]

PMID: 23084127

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Project description:Background: Progressive retinal neuroaxonal damage after acute optic neuritis may occur in neuromyelitis optica spectrum disorder (NMOSD). However, it is unclear if treatments used to prevent attacks influence neurodegeneration. Objectives: We aimed to investigate retinal damage in patients treated with disease-modifying drugs in a longitudinal study. Methods: We retrospectively included 50 patients with aquaporin 4-antibody-seropositive NMOSD. Peripapillary retinal nerve fiber layer (pRNFL) thickness, macular ganglion cell complex (mGCC) thickness, total macular volume (TMV), and optic disc measures were acquired by spectral domain optical coherence tomography in patients treated with tocilizumab, rituximab, and azathioprine. Results: Longitudinally, in eyes with a history of ON (NMOSDON+), we observed annual thinning of mGCC [tocilizumab: -1.77 (-3.44, -0.09) μm, p = 0.041; rituximab: -2.03 (-3.58, -0.48) μm, p = 0.017; azathioprine: -1.79 (-2.22, -1.37) μm, p < 0.001], and pRNFL [tocilizumab: -2.07 (-0.75, -3.39) μm, p = 0.005; rituximab: -2.18 (-0.36, -4.00) μm, p = 0.023; azathioprine: -2.37 (-0.98, -3.75) μm, p = 0.003], reduced TMV [tocilizumab: -0.12 (-0.22, -0.01) mm3, p = 0.028; rituximab: -0.15 (-0.21, -0.08) mm3, p = 0.001; azathioprine: -0.12 (-0.20, -0.04) mm3, p = 0.006], and increased cup area [tocilizumab: 0.08 (-0.01, 0.16) mm2, p = 0.010; rituximab: 0.07 (0.01, 0.12) mm2, p = 0.019; azathioprine: 0.14 (0.02, 0.26) mm2, p = 0.023]. However, we detected no significant differences in annual changes in mGCC, pRNFL, TMV, and cup area between patients with tocilizumab, rituximab, and azathioprine in NMOSDON+ eyes. NMOSDON- eyes did not display mGCC or pRNFL thinning in patients treated with tocilizumab and rituximab. Intriguingly, we observed significant thinning of mGCC in patients treated with azathioprine compared with tocilizumab [-0.84 (-1.50, -0.18) μm vs. -0.19 (-0.87, 0.48) μm, p = 0.012] and rituximab [-0.84 (-1.50, -0.18) μm vs. -0.07 (-1.25, -2.51) μm, p = 0.015] in NMOSDON- eyes. Conclusions: This study demonstrated that retinal ganglion cell loss is independent of ON attacks in NMOSD. Tocilizumab and rituximab may delay mGCC thinning in NMOSDON- eyes compared with azathioprine.

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Dataset Information

Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography.

Purpose

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Publications

Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography.

Similar Datasets

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