My neurologist has suggested that I get a Retinal Nerve Fiber Layer (RNFL) imaging of my eyes. The equipment used is an Optical Coherence Tomography machine. The test is non-invasive, and quick. I do not know if insurance will make payment for MS, but my understanding is the cost is minimal. The neuro believes the test will be used in standard treatment of MS within the next couple of years. My non-scientific understanding of the test is: measurement of a bundle of nerves in the eye (the nerves do not normally have myelin). The size of the bundle is compared to a standard based on age at the first test. The second test is compared to the patients first test. There is a correlation to decrease in size of the bundle to disability and also to the size of the brain. Here is a medical explanation:
Optical coherence tomography in multiple sclerosis.Frohman E, Costello F, Zivadinov R, Stuve O, Conger A, Winslow H, Trip A, Frohman T, Balcer L.
Department of Neurology, University of Texas Southwestern Medical Center at Dallas, 75235, USA. email@example.com
We do not have currently satisfactory clinical and anatomical correlates to gauge disability in multiple sclerosis. Structural biomarkers (such as MRI) are hindered because they cannot precisely segregate demyelination from axonal elements of tissue injury within the CNS. Axonal degeneration in multiple sclerosis is related to irreversible disability, which suggests that the confirmation of neuroprotective strategies needs highly quantifiable measures of axon loss that can be correlated with reliable measures of physiological function. The coupling of quantifiable measures of visual function with ocular imaging techniques, such as optical coherence tomography, enables us to begin to understand how structural changes in the visual system influence function in patients with multiple sclerosis. In this review, we consider the usefulness of optical imaging of the retina as a biomarker for neurodegeneration in multiple-sclerosis.
PMID: 16987732 [PubMed - indexed for MEDLINE]
I plan on getting the test soon. Optomologists are currently being trained. FYI for anyone living in the Denver, CO area - Dr. Karen Repine
was recommended by the neuro.
Take care everyone,