Macular Volume Determined by Optical Coherence Tomography as a Measure of Neuronal Loss in Multiple Sclerosis

AbstractOptical coherence tomography (OCT) grew out of a convergence of rapid advancements in femtoseconds optics research and fiber optic commercial technology. The basic concept of OCT is to “see” into tissues using light echoes, analogous to the sound echoes of ultrasonography. Multiple A-scans are assembled into a B-scan two-dimensional image of the tissue of interest. Retina is an ideal tissue for evaluation by OCT, since the eye is designed to minimize light scattering through the anterior chamber and vitreous. OCT has had a significant impact on the field of multiple sclerosis, where it has allowed direct imaging of the myelin-free segments of axons and cell bodies of retinal ganglion cells. Together with precise functional measurements of the afferent visual system, the addition of robust structural measurements of retinal injury has allowed for an unprecedented ability to correlate clinical effects with the degree of neuronal loss. In addition, OCT has proven helpful to distinguish different forms of demyelinating disease, such as multiple sclerosis (MS) and neuromyelitis optica, and has provided ideal outcome measures in remyelination and neuroprotection trials.

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High-Resolution Spectral Domain-Optical Coherence Tomography in Multiple Sclerosis, Part II – the Total Macular Volume. The First Follow-Up Study over 2 Years

Frontiers in Neurology ◽

10.3389/fneur.2014.00020 ◽

2014 ◽

Vol 5 ◽

Cited By ~ 9

Author(s):

Nermin Serbecic ◽

Fahmy Aboul-Enein ◽

Sven C. Beutelspacher ◽

Adnan Khan ◽

Clemens Vass ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

High Resolution ◽

Spectral Domain ◽

Optical Coherence ◽

Follow Up Study ◽

Macular Volume

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Correlation of optic neuritis and retinal nerve fibre thickness using optical coherence tomography in a cohort of multiple sclerosis patients

African Vision and Eye Health ◽

10.4102/aveh.v75i1.325 ◽

2016 ◽

Vol 75 (1) ◽

Author(s):

Izanne Roos ◽

Rajeshree Budhoo ◽

Linda Visser ◽

Ahmed I. Bhigjee

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Nerve Fibre ◽

Optical Coherence ◽

Macular Volume ◽

Rnfl Thickness ◽

Significant Difference ◽

History Of ◽

Multiple Sclerosis Patients

Background: Optical coherence tomography (OCT) is a fast, non-invasive imaging technology that produces 3D, high-resolution images of the retina. Direct visualisation of the retina allows a unique opportunity to study the effects of multiple sclerosis (MS)-associated neurodegeneration on retinal ganglion cells as well as effects of retrobulbar demyelination on axonal and retinal architecture through measurement of retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV). These findings are clinically important as axonal loss is irreversible and correlates with disability.Aim: To determine the role and usefulness of OCT in a local cohort of MS patients.Setting: Neurology Clinic, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa.Methods: Nineteen patients with MS currently being treated with interferon β-1b underwent OCT examination of both eyes. RNFL thickness and macular volume were measured and correlated with clinical disease characteristics, history of optic neuritis and level of disability.Results: Mean RNFL thickness was 77.3 μm with no significant difference in mean RNFL in eyes with a history of optic neuritis (ON) and those without (p = 0.4). Eyes with a history of ON did, however, have significantly thinner RNFL compared with the contralateral eye (p = 0.04). Despite a strong correlation between TMV and RNFL (p = 0.001), a subset of patients with normal RNFL had TMV that was less than 1% of what was expected. There was no correlation between RNFL and disability scores.Conclusion: OCT enables a direct axonal ‘optical biopsy’, for monitoring disease progression and treatment response in MS. RNFL thinning occurs independently of a history of optic neuritis and may represent a chronic optic neuropathy in patients with MS.Keywords: Multiple sclerosis; optical coherence tomography

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Optical coherence tomography outcomes from SPRINT-MS, a multicenter, randomized, double-blind trial of ibudilast in progressive multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458520964409 ◽

2020 ◽

pp. 135245852096440

Author(s):

Robert A Bermel ◽

Janel K Fedler ◽

Peter Kaiser ◽

Cindy Novalis ◽

Jeff Schneebaum ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Volume Change ◽

Outcome Measure ◽

Progressive Multiple Sclerosis ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Double Blind ◽

Thickness Change ◽

Macular Volume

Background: The SPRINT-MS trial demonstrated benefit of ibudilast on brain atrophy over 96 weeks in progressive multiple sclerosis (MS). Optical coherence tomography (OCT) was performed in all trial participants. Objective: Report the OCT results of the SPRINT-MS trial. Methods: OCT was obtained at baseline and every 6 months using spectral domain OCT and analyzed by an OCT reading center. Change in each OCT outcome measure by treatment group was estimated using linear mixed models. Results: Change in pRNFL thickness was +0.0424 uM/year (95% confidence interval (CI): −0.3091 to 0.3939) for ibudilast versus −0.2630 uM (95% CI: −0.5973 to 0.0714) for placebo ( n = 244, p = 0.22). Macular volume change was −0.00503 mm3/year (−0.02693 to 0.01688) with ibudilast versus −0.03659 mm3/year (−0.05824 to −0.01494) for placebo in the Spectralis cohort ( n = 61, p = 0.044). For the Cirrus cohort, macular volume change was −0.00040 mm3/year (−0.02167, 0.020866) with ibudilast compared to −0.02083 mm3/year (−0.04134 to −0.00033) for placebo ( n = 183, p = 0.1734). Ganglion cell-inner plexiform layer thickness change, available from Cirrus, was −0.4893 uM/year (−0.9132, −0.0654) with ibudilast versus −0.9587 uM/year (−1.3677, −0.5498) with placebo ( n = 183, p = 0.12). Conclusion: Retinal thinning in MS may be attenuated by ibudilast. Sample size estimates suggest OCT can be a viable outcome measure in progressive MS trials if a therapy has a large treatment effect. Trial registration: NN102/SPRINT-MS ClinicalTrials.gov number, NCT01982942.

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