Sarah Chaoying Xu1, Randy H Kardon1, Jacqueline A Leavitt1, Eoin P Flanagan1, Sean J Pittock1, John J Chen2. 1. From the Departments of Ophthalmology (S.C.X., J.A.L., J.J.C.) and Neurology (E.P.F., S.J.P., J.J.C.), Mayo Clinic, Rochester, MN; and Department of Ophthalmology (R.H.K.), University of Iowa, Iowa City. 2. From the Departments of Ophthalmology (S.C.X., J.A.L., J.J.C.) and Neurology (E.P.F., S.J.P., J.J.C.), Mayo Clinic, Rochester, MN; and Department of Ophthalmology (R.H.K.), University of Iowa, Iowa City. Chen.john@mayo.edu.
Abstract
OBJECTIVE: To explore sensitivity of optical coherence tomography (OCT) in detecting prior unilateral optic neuritis. METHODS: This is a retrospective, observational clinical study of all patients who presented from January 1, 2014, to January 6, 2017, with unilateral optic neuritis and OCT available at least 3 months after the attack. We compared OCT retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses between affected and unaffected contralateral eyes. We excluded patients with concomitant glaucoma or other optic neuropathies. Based on analysis of normal controls, thinning was considered significant if RNFL was at least 9 µm or GCIPL was at least 6 µm less in the affected eye compared to the unaffected eye. RESULTS: Fifty-one patients (18 male and 33 female) were included in the study. RNFL and GCIPL thicknesses were significantly lower in eyes with optic neuritis compared to unaffected eyes (p < 0.001). RNFL was thinner by ≥9 µm in 73% of optic neuritis eyes compared to the unaffected eye. GCIPL was thinner by ≥6 µm in 96% of optic neuritis eyes, which was more sensitive than using RNFL (p < 0.001). When using a threshold ≤1st percentile of age-matched controls, sensitivities were 37% for RNFL and 76% for GCIPL, each of which was lower than those calculated using the intereye difference as the threshold (p < 0.01). CONCLUSIONS: OCT, especially with GCIPL analysis, is a highly sensitive modality in detecting prior optic neuritis, which is made more robust by using intereye differences to approximate change. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that OCT accurately identifies patients with prior unilateral optic neuritis.
OBJECTIVE: To explore sensitivity of optical coherence tomography (OCT) in detecting prior unilateral optic neuritis. METHODS: This is a retrospective, observational clinical study of all patients who presented from January 1, 2014, to January 6, 2017, with unilateral optic neuritis and OCT available at least 3 months after the attack. We compared OCT retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses between affected and unaffected contralateral eyes. We excluded patients with concomitant glaucoma or other optic neuropathies. Based on analysis of normal controls, thinning was considered significant if RNFL was at least 9 µm or GCIPL was at least 6 µm less in the affected eye compared to the unaffected eye. RESULTS: Fifty-one patients (18 male and 33 female) were included in the study. RNFL and GCIPL thicknesses were significantly lower in eyes with optic neuritis compared to unaffected eyes (p < 0.001). RNFL was thinner by ≥9 µm in 73% of optic neuritis eyes compared to the unaffected eye. GCIPL was thinner by ≥6 µm in 96% of optic neuritis eyes, which was more sensitive than using RNFL (p < 0.001). When using a threshold ≤1st percentile of age-matched controls, sensitivities were 37% for RNFL and 76% for GCIPL, each of which was lower than those calculated using the intereye difference as the threshold (p < 0.01). CONCLUSIONS: OCT, especially with GCIPL analysis, is a highly sensitive modality in detecting prior optic neuritis, which is made more robust by using intereye differences to approximate change. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that OCT accurately identifies patients with prior unilateral optic neuritis.
Authors: Axel Petzold; Sharon Y L Chua; Anthony P Khawaja; Pearse A Keane; Peng T Khaw; Charles Reisman; Baljean Dhillon; Nicholas G Strouthidis; Paul J Foster; Praveen J Patel Journal: Brain Date: 2021-02-12 Impact factor: 13.501
Authors: Friedemann Paul; Peter A Calabresi; Frederik Barkhof; Ari J Green; Randy Kardon; Jaume Sastre-Garriga; Sven Schippling; Patrick Vermersch; Shiv Saidha; Bianca S Gerendas; Ursula Schmidt-Erfurth; Catherine Agoropoulou; Ying Zhang; Gustavo Seifer; Axel Petzold Journal: Ann Clin Transl Neurol Date: 2021-11-18 Impact factor: 4.511
Authors: Axel Petzold; Philipp Albrecht; Laura Balcer; Erik Bekkers; Alexander U Brandt; Peter A Calabresi; Orla Galvin Deborah; Jennifer S Graves; Ari Green; Pearse A Keane; Jenny A Nij Bijvank; Josemir W Sander; Friedemann Paul; Shiv Saidha; Pablo Villoslada; Siegfried K Wagner; E Ann Yeh Journal: Ann Clin Transl Neurol Date: 2021-05-19 Impact factor: 4.511