That's interesting and I'll be interested to read more of the specifics.
Although optic neuritis is a common early symptom of MS, not everyone experiences ON. My wife doesn't and has been to the ophthalmologist and checked for ON recently.
I wonder if the retinal fiber thickness still correctly correlates even though someone might not have ON?
My neurologist believes this will become a standard test used in the treatment of MS.
I don't understand the reasoning behind it, but you're right.
Optical coherence tomography (OCT), a relatively new imaging technique, is a promising and sensitive tool that measures the thickness of the retinal nerve fiber layer (RNFL)15,16 and costs approximately 10 to 15% that of MRI. Recent studies have shown that OCT can detect RNFL thinning, possibly due to axon damage, within the retinas of patients with MS regardless of clinical history of optic neuritis,17–19 suggesting that it may be an effective biomarker of destructive disease.20,21
© 2007 American Academy of Neurology
Diagnostic accuracy of retinal abnormalities in predicting disease activity in MS
Jorge Sepulcre, MD, Manuel Murie-Fernandez, MD, Angel Salinas-Alaman, MD, Alfredo García-Layana, MD, Bartolome Bejarano, MD and Pablo Villoslada, MD
Objectives: To assess the association between the thickness of the retinal nerve fiber layer (RNFL), assessed by optical coherence tomography (OCT), retinal periphlebitis (RP), and multiple sclerosis (MS) disease activity.
Methods: We studied a prospective cohort of 61 patients and 29 matched controls for 2 years, performing a neurologic assessment every 3 months and an ophthalmologic evaluation, including OCT scans, every 6 months. Baseline MRI studies were also carried out from which brain volume and lesion load were assessed.
Results: We found that the RNFL thickness in patients with MS was thinner than in controls, particularly in the temporal quadrant (p = 0.004). Although RNFL atrophy was greater in patients who also had optic neuritis (p = 0.002), it also augmented in MS patients who did not have optic neuritis compared with controls (p = 0.014). RNFL atrophy was correlated with greater disability (r = –0.348, p = 0.001) and longer disease duration (r = –0.301, p = 0.003). Furthermore, baseline temporal quadrant RNFL atrophy was associated with the presence of new relapses and changes in the Expanded Disability Status Scale by the end of the study (p < 0.05 in all cases). Indeed, RNFL thickness was correlated with white matter volume (r = 0.291, p = 0.005) and gray matter volume (r = 0.239, p = 0.021). The presence of RP was a risk factor for having new relapses in the next 2 years (odds ratio = 1.52, p = 0.02), and patients with RP had larger gadolinium-enhancing lesions volume (p = 0.003).
Conclusion: Retinal nerve fiber layer atrophy and the presence of retinal periphlebitis are associated with disease activity, suggesting that retinal evaluation can be used as biomarkers of multiple sclerosis activity.
*Both authors contributed equally to this work.
Supported in part by the Spanish Ministry of Health (FIS PI051201), the "Fundacion Uriach" and by an unrestricted grant by Gemac SA (Cenon, France) to P.V. J.S. was a fellow of the Spanish Ministry of Health (FIS CM #05/00222).
Disclosure: The authors report no conflicts of interest.
Received September 16, 2006. Accepted in final form December 31, 2006.
Thanks for the additional information Carolsue.carolsue wrote:Results: We found that the RNFL thickness in patients with MS was thinner than in controls, particularly in the temporal quadrant (p = 0.004). Although RNFL atrophy was greater in patients who also had optic neuritis (p = 0.002), it also augmented in MS patients who did not have optic neuritis compared with controls (p = 0.014).
If this continues to prove out I think it could be a valuable new tool. I just was having a little trouble figuring out how the researchers felt that this direct correlation to what is going on in the brain transferred out to the retinal nerve fiber bundle in the eyeball without inflaming the optic nerves in the process but I notice that the semantics they used might have gone over my head on first reading.
They don't say "regardless of optical neuritis" (inflammation of the optic nerve) but instead say "regardless of clinical history of optic neuritis", which means "regardless of diagnosis of optic neuritis" and that seems sensible enough.
- Similar Topics
- Last post