OBJECTIVE: We set out to assess the dynamics of retinal injury after acute optic neuritis (ON) and their association with clinical visual outcomes. METHODS: Thirty-one consecutive patients with acute ON were prospectively analyzed over a 6-month follow-up period. Each month, we used optical coherence tomography (OCT) to assess the thickness of peripapillary retinal nerve fiber layer (pRNFL) and segmented macular layers, as well as high-contrast visual acuity, low-contrast visual acuity (LCVA), color visual acuity (CVA), and visual fields (VF). RESULTS: In this prospective study, we found that 6 months after clinical onset, ON eyes suffered a reduction in pRNFL (-45.3 μm) and macular thickness (-17.3 μm). Macular atrophy was due to the decrease of macular RNFL thickness (-7.8 μm) and that of the ganglion cell layer and inner plexiform layer (GCIP, -11.3 μm), whereas the thickness of the outer retinal layers increased slightly. The macular RNFL and GCIP thickness decreased in parallel, yet it always occurred more rapidly and more severely for the GCIP. The change in the GCIP thickness in the first month predicted the visual impairment by month 6; a decrease ≥ of 4.5 μm predicted poor LCVA (sensitivity of 93% and specificity of 88%), and a decrease of ≥ 7 μm predicted poor VF and CVA (sensitivity of 78% and 100% and specificity of 63% and 66%, respectively). INTERPRETATION: Retinal axonal and neuronal damage develops quickly after ON onset. Assessment of ganglion cell layer thickness by OCT after ON onset can be used as an imaging marker of persistent visual disability.
OBJECTIVE: We set out to assess the dynamics of retinal injury after acute optic neuritis (ON) and their association with clinical visual outcomes. METHODS: Thirty-one consecutive patients with acute ON were prospectively analyzed over a 6-month follow-up period. Each month, we used optical coherence tomography (OCT) to assess the thickness of peripapillary retinal nerve fiber layer (pRNFL) and segmented macular layers, as well as high-contrast visual acuity, low-contrast visual acuity (LCVA), color visual acuity (CVA), and visual fields (VF). RESULTS: In this prospective study, we found that 6 months after clinical onset, ON eyes suffered a reduction in pRNFL (-45.3 μm) and macular thickness (-17.3 μm). Macular atrophy was due to the decrease of macular RNFL thickness (-7.8 μm) and that of the ganglion cell layer and inner plexiform layer (GCIP, -11.3 μm), whereas the thickness of the outer retinal layers increased slightly. The macular RNFL and GCIP thickness decreased in parallel, yet it always occurred more rapidly and more severely for the GCIP. The change in the GCIP thickness in the first month predicted the visual impairment by month 6; a decrease ≥ of 4.5 μm predicted poor LCVA (sensitivity of 93% and specificity of 88%), and a decrease of ≥ 7 μm predicted poor VF and CVA (sensitivity of 78% and 100% and specificity of 63% and 66%, respectively). INTERPRETATION: Retinal axonal and neuronal damage develops quickly after ON onset. Assessment of ganglion cell layer thickness by OCT after ON onset can be used as an imaging marker of persistent visual disability.
Authors: Janine Mikolajczak; Hanna Zimmermann; Ahmad Kheirkhah; Ella Maria Kadas; Timm Oberwahrenbrock; Rodrigo Muller; Aiai Ren; Joseph Kuchling; Holger Dietze; Harald Prüss; Friedemann Paul; Pedram Hamrah; Alexander U Brandt Journal: Mult Scler Date: 2016-11-03 Impact factor: 6.312
Authors: Magí Andorrà; Salut Alba-Arbalat; Anna Camos-Carreras; Iñigo Gabilondo; Elena Fraga-Pumar; Ruben Torres-Torres; Irene Pulido-Valdeolivas; Ana I Tercero-Uribe; Ana M Guerrero-Zamora; Santiago Ortiz-Perez; Irati Zubizarreta; Nuria Sola-Valls; Sara Llufriu; Maria Sepulveda; Eugenia Martinez-Hernandez; Thais Armangue; Yolanda Blanco; Pablo Villoslada; Bernardo Sanchez-Dalmau; Albert Saiz; Elena H Martinez-Lapiscina Journal: JAMA Neurol Date: 2020-02-01 Impact factor: 18.302
Authors: Elena H Martinez-Lapiscina; Maria Sepulveda; Ruben Torres-Torres; Salut Alba-Arbalat; Sara Llufriu; Yolanda Blanco; Ana M Guerrero-Zamora; Nuria Sola-Valls; Santiago Ortiz-Perez; Pablo Villoslada; Bernardo Sanchez-Dalmau; Albert Saiz Journal: Ther Adv Neurol Disord Date: 2016-08-15 Impact factor: 6.570