scholarly journals The Effect of Multiple Sclerosis on Nerve Fiber Layer of the Retina

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A A Mohamed ◽  
A M Saad ◽  
T H Mohamed ◽  
Y A Elzanklony
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Optic Neuritis ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Slit Lamp ◽  
University Hospitals ◽  
Rnfl Thickness ◽  
Study Results ◽  
Significant Difference

Abstract Background Multiple Sclerosis is a chronic idiopathic inflammatory demyelinating disease involving Central Nervous System white matter with relapsing-remitting nature. Optic neuritis is a common initial manifestation. Multiple Sclerosis is characterized by dual pathological process of inflammation and neurodegeneration. It causes prominent retinal neural ganglion cell layer loss in addition to related axonal loss which can be identified by thinning of RNFL seen in OCT. Patients and Methods This case control study was carried out at Ain Shams University Hospitals in MS clinic of neurology department and Ophthalmology outpatient clinics. with a total of 100 eyes, from 50 subjects, Group A (10 patients, 20 eyes): normal persons with normal eyes as a Control group and 40 patients (80 eyes) having multiple sclerosis who satisfied the inclusion and exclusion criteria subdivided into 2 groups,(group B) 20 patients having previous attack of Optic Neuritis & (group C) 20 patients not having previous Optic Neuritis. Informed consents were obtained from all subjects and ethics approval were obtained from Ain Shams University Hospitals Ethical Commitee: A complete ophthalmic history and ophthalmological examination were done for each subject. Visual acuity assessment using Auto Refractometer, refraction, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) assessment using Snellen chart and also calculated in Logarithm of Minimum Angle of Resolution (LogMAR).Pupil reaction. Color vision assessment. Anterior segment detailed Slit Lamp examination. Posterior segment examination (ONH examination) using Slit lamp biomicroscopy, Volk +90 Diopter lens. Intraocular tension measured by Goldmann applanation tonometry. OCT to evaluate RNF layer thickness and c/d ratio. Results Our study results demonstrated that: VA & BCVA were statistically significant lower in MS group than the control group (P = 0.011, 0.006 respectively). Total, superior, inferior and temporal RNFL thickness were statistically significant lower in MS group than the control group(P = 0.003, 0.004, 0.028, 0.018 respectively), while there was no statistically significant difference between the two studied groups regarding nasal RNFL thickness. Total, all the four quadrants superior, inferior, temporal and nasal RNFL thickness were statistically significant lower in MS group with previous attack of ON compared with the MS group not having previous ON (P = 0.000, 0.000, 0.004, 0.004, 0.024 respectively). Conclusion This study also suggests a great role of ocular imaging techniques such as OCT as an effective noninvasive, high-resolution, non contact tool in mapping of subclinical retinal changes (GCIP layer) in MS patients. It may also serve as a diagnostic adjunct for monitoring disease activity and responses to neuroprotective drugs.

Static and dynamic pupillary characteristics in multiple sclerosis

2021 ◽  
pp. 112067212110443
Author(s):  
Ersin Muhafiz ◽  
Erdinç Bozkurt ◽  
Can Emre Erdoğan ◽  
Şerif Nizamoğulları ◽  
Mehmet Siraç Demir
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Control Group ◽  
Fiber Layer ◽  
Time Intervals ◽  
Rnfl Thickness ◽  
Significant Difference ◽  
Ophthalmologic Examination ◽  
And Control

Purpose: To examine the static and dynamic pupillary functions with automated pupillography in multiple sclerosis (MS) patients with preserved visual acuity. Methods: Forty-seven MS patients with preserved visual acuity were included in the study group and 43 healthy volunteers in the control group. The visual evoked potential of the patients was obtained. After routine ophthalmologic examination contrast sensitivity and the retinal nerve fiber layer (RNFL) thickness were measured. Finally scotopic, mesopic, and photopic pupillographies followed by dynamic pupillography were undertaken, and the pupillary dilatation speed was calculated. Results: The contrast sensitivity and RNFL thickness of the MS group were significantly lower than those of the control group ( p < 0.05; for both). In the MS and control groups, the scotopic pupil diameters were 5.48 ± 1.03 and 5.28 ± 0.78 mm, mesopic pupil diameters were 4.82 ± 0.83 and 4.48 ± 0.70 mm, and photopic pupil diameters were 3.84 ± 0.79 and 3.42 ± 0.49 mm, respectively ( p = 0.315, p = 0.044, and p = 0.004, respectively). In dynamic pupillography, the pupil in the MS group was more dilated than control group at all time sections examined except the sixth second ( p < 0.05; for all). Although the mean pupillary dilation speed in the first second was higher in the MS group ( p = 0.044), there was no significant difference between the groups for the other time intervals examined ( p > 0.05; for all). There was no correlation between pupillary parameters and P100-wave latency, RNFL thickness, or contrast sensitivity ( p > 0.05; for all). Conclusions: Static and dynamic pupillary functions may be affected in MS patients with preserved visual acuity. Although scotopic pupillary functions are preserved, mesopic, and photopic pupil functions are weakened.

scholarly journals Influence of diabetes mellitus on corneal thickness

2014 ◽  
Vol 142 (9-10) ◽  
pp. 529-534 ◽  
Author(s):  
Ivan Sencanic ◽  
Miroslav Stamenkovic ◽  
Vesna Jovanovic ◽  
Sinisa Babovic ◽  
Vesna Jaksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Healthy Subjects ◽  
Corneal Thickness ◽  
Ultrastructural Changes ◽  
Control Group ◽  
Diabetic Patients ◽  
Ophthalmological Examination ◽  
Study Results ◽  
Significant Difference

Introduction. Ultrastructural changes in corneas of patients with diabetes mellitus have been previously described. Objective. The aim of this study was to compare central corneal thickness (CDR) values in diabetic patients without retinopathy at the stage of diabetic nonproliferative and proliferative retinopathy and CDR in a control group of healthy subjects. Methods. The study included 121 diabetic patients and 125 healthy subjects matched according to gender and age. Each patient underwent ophthalmological examination involving a dilated fundus examination and CDR measurement using the ultrasound pachymeter. The eyes of diabetic patients were classified according to Early Treatment Diabetic Retinopathy Study into three groups: without diabetic retinopathy (NDR), with nonproliferative diabetic retinopathy (NPDR) and a group with proliferative diabetic retinopathy (PDR). Only one eye of each subject was chosen for the study. Results. The mean CDR value was significantly higher in the diabetic group (570.52?31.81 ?m) compared with the control group (541.42?27.82 ?m). The difference between the two groups was statistically significant (p<0.0001). The highest mean CDR value was recorded in the PDR group (585.97?28.58 ?m), followed by the NPDR group (570.84?30.27 ?m), whereas the lowest mean CDR value was recorded in the NDR group (559.80?31.55 ?m). There was a statistically significant difference in CDR between the NDR and PDR groups, as well as between the NPDR and PDR groups (p<0.001, p<0.05 respectively). No significant difference was recorded between the NDR and NPDR groups (p>0.05). Conclusion. CDR of diabetic patients was higher compared to healthy subjects. The highest mean value of CDR was registered in the PDR group, followed by the NPDR and the NDR groups.

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

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

scholarly journals Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis With and Without Optic Neuritis: a Four-year Follow-up Study

2021 ◽  
Author(s):  
Abdullah S. Al-Mujaini ◽  
Maiysa S. Al-Mujaini ◽  
Buthaina I. Sabt
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Control Group ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Rnfl Thickness

Abstract Background: Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system, with optic neuritis (ON) being a common early manifestation. Retinal nerve fiber layer (RNFL) thickness may be a biomarker of neuroaxonal damage in MS patients. We sought to evaluate changes in RNFL thickness over four years in Omani MS patients with or without ON in comparison to a healthy control group. Methods: This retrospective case-control study involved 27 MS patients and 25 healthy controls. Optical coherence tomography was performed upon first diagnosis and at a four-year follow-up. Differences in mean RNFL thickness were calculated. Results: A total of 51 eyes from the MS group and 50 eyes from the control group were evaluated. There was a significant reduction in mean RNFL thickness among MS patients with ON at follow-up (81.21 versus 72.14 µm; P = .003), whereas no significant RNFL thinning was observed among MS patients without ON. However, there was a significant reduction in RNFL thickness among MS patients compared to healthy controls (76.79 versus 93.72 µm; P = .009), regardless of ON presence/absence. Conclusions: Axonal damage was seen in the optic nerves of Omani MS patients. Moreover, there was a significant reduction in RNFL thickness among MS patients with ON as the disease progressed; however, while there was evidence of RNFL thinning in MS patients without ON, this difference lacked statistical significance. Evaluation of RNFL thickness may represent a useful biomarker for monitoring disease progression in MS and its association with ON.

scholarly journals Assessment of the optic nerve, optic disc, and perineural area using shear-wave elastography in patients with multiple sclerosis

2021 ◽  
Author(s):  
Suna Sahin Ediz ◽  
Basak Atalay ◽  
Ilknur Aydın Canturk ◽  
Adnan Kabaalioglu
Keyword(s):  
Multiple Sclerosis ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Optic Disc ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Optic Nerves ◽  
Significant Difference ◽  
The Mean

Purpose: To observe and describe the stiffness changes of the optic nerve in the patients with multiple sclerosis (MS) with or without optic neuritis and healthy adults via shear wave elastography (SWE). Methods: Seventy optic nerves from thirty-five patients with MS and sixty optic nerves from thirty healthy subjects were included prospectively in the study. The optic nerve (ON), optic disc (OD), and perineural area were evaluated with SWE and optic nerve sheat diameter (ONSD) was measured by ultrasound. Results The mean age of patients was 39.68 ± 9.99 years. There was no statistically significant difference between the groups in terms of ONSD, SWE ON, SWE OD, and SWE perineural area levels (p> 0.05). In the MS group; No statistically significant difference was found between patients with and without optic neuritis for the mean age, gender distribution, duration of MS, types of MS, ONSD, SWE ON, SWE OD, SWE perineural area, and Expanded Disability Status Scale (EDSS) scores (p> 0.05). No statistically significant difference in terms of ONSD, SWE ON, SWE OD, and SWE perineural area between the MS patients with or without optic neuritis and the control group (p> 0.05). Conclusion: Shear wave elastography measurements of the optic nerve, optic disc, and perineural area do not contribute to the evaluation of optic neuritis in a patient with MS.

scholarly journals A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Sameh S. Mandour ◽  
Khaled E. Said-Ahmed ◽  
Hany A. Khairy ◽  
Moataz F. Elsawy ◽  
Marwa A. Zaky
Keyword(s):  
Nasolacrimal Duct ◽  
Ophthalmological Examination ◽  
Slit Lamp ◽  
University Hospitals ◽  
Silicone Tube ◽  
Significant Difference ◽  
Fluorescein Dye ◽  
The Difference ◽  
One Year ◽  
Punctal Stenosis

Purpose. Evaluation of using pigtail probe to detect and open severely stenosed lower lacrimal punctum followed by self-retaining bicanalicular intubation. Study design. A prospective nonrandomized clinical study. Methods. The study included 24 patients with severe lower punctal stenosis (grade 0 according to Kashkouli scale) attending at Menoufia University Hospitals. The upper punctum and canaliculus were patent. All patients were complaining of epiphora and had a thorough ophthalmological examination including dye disappearance test and slit-lamp examination. Pigtail probe was used from patent upper punctum to detect the lower stenosed punctum which was opened with a scalpel. Syringing of the lower lacrimal passages was done to confirm its patency, and self-retaining silicone bicanalicular stent was inserted. The silicone tube was left in place for 6 months before it was removed. Patients were then followed-up for 1 year after the surgery. Results. One year after surgery, epiphora was absent (grade 0) in 16 eyes (66.7%) and was present only occasionally (grade 1) in 4 eyes (16.7%). The difference from preoperative epiphora was statistically significant. One year after surgery, fluorescein dye disappearance time was grade 1 (<3 minutes) in 20 cases (83.3%), and grade 2 (3–5 minutes) in 4 cases (16.7%). There was a statistically significant difference compared with preoperative results. Conclusion. Using the pigtail probe is effective in treatment of severe punctal stenosis. Maintaining the punctal opening and prevention of restenosis can be achieved by using self-retaining bicanalicular stent after confirmation of nasolacrimal duct patency. This trial is registered with NCT03731143.

scholarly journals Fatigue and Associated Factors in Multiple Sclerosis Patients in Latvia

2018 ◽  
Vol 22 (75) ◽  
pp. 42-48
Author(s):  
S. Šetlere ◽  
A. Abelsen ◽  
D. Pastare ◽  
A. Millers
Keyword(s):  
Multiple Sclerosis ◽  
Cross Sectional Study ◽  
Lifestyle Factor ◽  
Control Group ◽  
Common Symptom ◽  
Neurological Disability ◽  
Cross Sectional ◽  
Study Results ◽  
Significant Difference ◽  
Multiple Sclerosis Patients

Background and objectives. Fatigue is one of the most common symptoms of multiple sclerosis (MS). The aim of this study was to determine the presence of fatigue in MS patients in Latvia and its relation to lifestyle factors, neurological disability and depression. Material and methods. This cross-sectional study included 117 participants (44 patients with MS and 73 healthy control group). Applied research instruments were: Expanded Disability Status Scale (EDSS), Patient Health Questionnaire (PHQ-9), Fatigue Severity Scale (FSS), and the general questionnaire for the collection of socio-demographic, lifestyle habits and clinical data constructed for the purposes of this study. Results. Mean FSS score was 3,9±1,9 in MS group. 26 (59,1%) patients had FSS score of 3,8 or more and were classified as a fatigue group (MSF) while 18 (40,9%) patients had FSS of 3,7 or less and were classified as a non-fatigue (MSNF) group. There was statistically significant difference between MSF and MSNF groups considering PHQ9 score (p=0,019), FSS score (p&amp;lt;0,001) and EDSS score (p&amp;lt;0,001). Significant correlations of fatigue with depression (r=0,48, p=0,001), fatigue with neurological disability (r=0,49, p=0,001) and fatigue with smoking (r=0,29, p=0,054) were confirmed. Conclusions. Fatigue is a common symptom in MS patients in Latvia. This study supports significant association between fatigue and clinical factors (disability, depression) and modifiable lifestyle factor – smoking.

scholarly journals Retinal nerve fiber layer thickness in multiple sclerosis with and without optic neuritis: a four-year follow-up study from Oman

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdullah S. Al-Mujaini ◽  
Maiysa S. Al-Mujaini ◽  
Buthaina I. Sabt
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Control Group ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Rnfl Thickness

Abstract Background Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system, with optic neuritis (ON) being a common early manifestation. Retinal nerve fiber layer (RNFL) thickness may be a biomarker of neuroaxonal damage in MS patients. We sought to evaluate changes in RNFL thickness over 4 years in Omani MS patients with or without ON in comparison to a healthy control group. Methods This retrospective case-control study involved 27 MS patients and 25 healthy controls. Optical coherence tomography was performed upon first diagnosis and at a four-year follow-up. Differences in mean RNFL thickness were calculated. Results A total of 51 eyes from the MS group and 50 eyes from the control group were evaluated. There was a significant reduction in mean RNFL thickness among MS patients with ON at follow-up (81.21 versus 72.14 μm; P = .003), whereas no significant RNFL thinning was observed among MS patients without ON. However, there was a significant reduction in RNFL thickness among MS patients compared to healthy controls (76.79 versus 93.72 μm; P = .009), regardless of ON presence/absence. Conclusions Axonal damage was seen in the optic nerves of Omani MS patients. Moreover, there was a significant reduction in RNFL thickness among MS patients with ON as the disease progressed; however, while there was evidence of RNFL thinning in MS patients without ON, this difference lacked statistical significance. Evaluation of RNFL thickness may represent a useful biomarker for monitoring disease progression in MS and its association with ON.

scholarly journals The influence of intravitreally applied triamcinolone acetonide on vitreal hemorrhage resorption and visual acuity in patients with proliferative diabetic retinopathy

2018 ◽  
Vol 146 (3-4) ◽  
pp. 131-135
Author(s):  
Nenad Petrovic ◽  
Dusan Todorovic ◽  
Suncica Sreckovic ◽  
Tatjana Sarenac-Vulovic ◽  
Mirjana Janicijevic-Petrovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Intraocular Pressure ◽  
Triamcinolone Acetonide ◽  
Proliferative Diabetic Retinopathy ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Intravitreal Triamcinolone ◽  
Intravitreal Triamcinolone Acetonide ◽  
Significant Difference

Introduction/Objective. Vitreal hemorrhage (VH) is one of the possible complications of the diabetic retinopathy which is followed by intensive decrease of visual acuity. Corticosteroides are commonly used in treatment of different retinal diseases, due to their antiinflammatory and anti-angiogenetic effect. Triamcinolone acetonide applied invtravitreally remains in the eye for several months, releases its crystals and decreases the density of vitreal hemorrhage. The aim of this study was to evaluate the efficacy of 20 mg intravitreal triamcinolone acetonide for the managementof long lasting VH, occurred as a complication of proliferative diabetic retinopathy (PDR) in non-vitrectomized eyes. Methods. In prospective study, from January 1st 2015 until the January 1st 2016, 24 patients with VH who received intravitreal triamcinolone acetonide, were compared to 21 patients from the control group (patients with PDR and similar degree of VH). All patients passed ophthalmological examination at the beginning of the study, 7 days, 1, 3, 6, 9 and 12 months after intravitreal application of 20mg triamcinolone acetonide. Besides VH and visual acuity, intraocular pressure and cataract development were also analyzed. Results. Statistically significant difference was recorded 1st and 3rd month after the usage of triamacinolone, in the density of vitreal hemorrhage and visual acuity. Twenty-nine percent of patients had temporally intraocular pressure rise after the intravitreal triamacinolone application, and 4.1% of patients ended the study with the developed cataract. Conclusion. Intravitreally applied triamcinolone acetonide has moderate and temporary influence on the velocity of vitreal hemorrhage reabsorption. It can be useful treatment option when the vitrectomy in not possible.

scholarly journals Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Tongue Base ◽  
Control Group ◽  
University Hospitals ◽  
Energy Field ◽  
Obstructive Sleep ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

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