BACKGROUND: Optical coherence tomography can be used to assess retinal degeneration in multiple sclerosis (MS). Thinning of the retinal nerve fibre layer and macular thickness have been well characterized, but newer devices allow quantification of all retinal layers. OBJECTIVES: The objective of this study was to evaluate the thickness of the paramacular retina, peripapillary retinal nerve fibre layer, and deeper paramacular layers in MS patient subgroups, using state-of-the-art optical coherence tomography. METHODS: Using a Heidelberg Engineering Spectralis device, we performed paramacular volumetric retinal scans and circular peripapillary fibre-layer scans, manually segmenting different retinal layers into single horizontal foveal scans in 95 patients with definite MS (42 relapsing-remitting, 41 secondary progressive, 12 primary progressive), plus 91 age- and sex-matched controls. RESULTS: Even without a history of optic neuritis, all MS subgroups had significant thinning of the peripapillary retinal nerve fibre layer, the paramacular retinal thickness and the retinal ganglion cell- and inner plexiform layer. Only in primary progressive MS was the inner nuclear layer significantly reduced. CONCLUSIONS: Our findings indicate a primary retinal pathology involving the inner nuclear layer in primary progressive MS. Results in eyes without history of optic neuritis suggest possible subclinical episodes of optic neuritis or retrograde trans-synaptic degeneration of retinal ganglion cells and their axons.
BACKGROUND: Optical coherence tomography can be used to assess retinal degeneration in multiple sclerosis (MS). Thinning of the retinal nerve fibre layer and macular thickness have been well characterized, but newer devices allow quantification of all retinal layers. OBJECTIVES: The objective of this study was to evaluate the thickness of the paramacular retina, peripapillary retinal nerve fibre layer, and deeper paramacular layers in MS patient subgroups, using state-of-the-art optical coherence tomography. METHODS: Using a Heidelberg Engineering Spectralis device, we performed paramacular volumetric retinal scans and circular peripapillary fibre-layer scans, manually segmenting different retinal layers into single horizontal foveal scans in 95 patients with definite MS (42 relapsing-remitting, 41 secondary progressive, 12 primary progressive), plus 91 age- and sex-matched controls. RESULTS: Even without a history of optic neuritis, all MS subgroups had significant thinning of the peripapillary retinal nerve fibre layer, the paramacular retinal thickness and the retinal ganglion cell- and inner plexiform layer. Only in primary progressive MS was the inner nuclear layer significantly reduced. CONCLUSIONS: Our findings indicate a primary retinal pathology involving the inner nuclear layer in primary progressive MS. Results in eyes without history of optic neuritis suggest possible subclinical episodes of optic neuritis or retrograde trans-synaptic degeneration of retinal ganglion cells and their axons.
Authors: Philipp Albrecht; Christine Blasberg; Marius Ringelstein; Ann-Kristin Müller; David Finis; Rainer Guthoff; Ella-Maria Kadas; Wolf Lagreze; Orhan Aktas; Hans-Peter Hartung; Friedemann Paul; Alexander U Brandt; Axel Methner Journal: J Neurol Date: 2017-06-05 Impact factor: 4.849
Authors: Berthold Pemp; Randy H Kardon; Karl Kircher; Elisabeth Pernicka; Ursula Schmidt-Erfurth; Andreas Reitner Journal: Graefes Arch Clin Exp Ophthalmol Date: 2013-04-16 Impact factor: 3.117
Authors: Gema Rebolleda; Laura Diez-Alvarez; Alfonso Casado; Carmen Sánchez-Sánchez; Elisabet de Dompablo; Julio J González-López; Francisco J Muñoz-Negrete Journal: Saudi J Ophthalmol Date: 2014-10-05
Authors: Shiv Saidha; Elias S Sotirchos; Mohamed A Ibrahim; Ciprian M Crainiceanu; Jeffrey M Gelfand; Yasir J Sepah; John N Ratchford; Jiwon Oh; Michaela A Seigo; Scott D Newsome; Laura J Balcer; Elliot M Frohman; Ari J Green; Quan D Nguyen; Peter A Calabresi Journal: Lancet Neurol Date: 2012-10-04 Impact factor: 44.182