Analysis of spectral domain optical coherence tomography measurements in optic neuritis: differences in neuromyelitis optica, multiple sclerosis, isolated optic neuritis and normal healthy controls

Background.Optical coherence tomography (OCT) has facilitated characterisation of retinal alterations in MS patients. Only scarce and in part conflicting data exists on different MS subtypes.Objective.To analyse patterns of retinal changes in different subtypes of MS with latest spectral-domain technology.Methods.In a three-centre cross-sectional study 414 MS patients and 94 healthy controls underwent spectral-domain OCT examination.Results.Eyes of MS patients without a previous optic neuritis showed a significant reduction of both retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) compared to healthy controls independent of the MS subtype (P<0.001for all subtypes). RNFL thickness was lower in secondary progressive MS (SPMS) eyes compared to relapsing-remitting MS (RRMS) eyes (P=0.007), and TMV was reduced in SPMS and primary progressive MS (PPMS) eyes compared to RRMS eyes (SPMS:P=0.039, PPMS:P=0.005). Independent of the subtype a more pronounced RNFL thinning and TMV reduction were found in eyes with a previous optic neuritis compared to unaffected eyes.Conclusion.Analysis of this large-scale cross-sectional dataset of MS patients studied with spectral-domain OCT confirmed and allows to generalize previous findings. Furthermore it carves out distinct patterns in different MS subtypes.

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Optical coherence tomography angiography indicates subclinical retinal disease in neuromyelitis optica spectrum disorders

Multiple Sclerosis Journal ◽

10.1177/13524585211028831 ◽

2021 ◽

pp. 135245852110288

Author(s):

Lilian Aly ◽

Eva-Maria Strauß ◽

Nikolaus Feucht ◽

Isabella Weiß ◽

Achim Berthele ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Disease Activity ◽

Optical Coherence Tomography Angiography ◽

Visual Performance ◽

Healthy Controls ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorders ◽

Spectrum Disorders

Background: Neuromyelitis optica spectrum disorders (NMOSD) are neuroinflammatory diseases of the central nervous system. Patients suffer from recurring relapses and it is unclear whether relapse-independent disease activity occurs and whether this is of clinical relevance. Objective: To detect disease-specific alterations of the retinal vasculature that reflect disease activity during NMOSD. Methods: Cross-sectional analysis of 16 patients with NMOSD, 21 patients with relapsing-remitting multiple sclerosis, and 21 healthy controls using retinal optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), measurement of glial fibrillary acidic protein (GFAP) serum levels, and assessment of visual acuity. Results: Patients with NMOSD but not multiple sclerosis revealed lower foveal thickness (FT) ( p = 0.02) measures and an increase of the foveal avascular zone (FAZ) ( p = 0.02) compared to healthy controls independent to optic neuritis. Reduced FT ( p = 0.01), enlarged FAZ areas ( p = 0.0001), and vessel loss of the superficial vascular complex ( p = 0.01) were linked to higher serum GFAP levels and superficial vessel loss was associated with worse visual performance in patients with NMOSD irrespective of optic neuritis. Conclusion: Subclinical parafoveal retinal vessel loss might occur during NMOSD and might be linked to astrocyte damage and poor visual performance. OCT-A may be a tool to study subclinical disease activity during NMOSD.

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Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study

Journal of Clinical Medicine ◽

10.3390/jcm10040609 ◽

2021 ◽

Vol 10 (4) ◽

pp. 609

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectrum Disorder ◽

Control Group ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary (RPC) vessel density in MS and NMOSD patients using optical coherence tomography angiography (OCTA). A total of 40 MS patients, 13 NMOSD patients, and 20 controls were included. The average RPC vessel density was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS−ON, NMOSD−ON) and in MS+ON, MS−ON, NMOSD+ON, and NMOSD−ON compared with the control group. In NMOSD+ON eyes, the vessel density in superior nasal, nasal superior, and inferior sectors was significantly more decreased than in MS+ON eyes. RPC reduction was also observed in inferior nasal and temporal superior sectors in MS−ON eyes compared with NMOSD−ON eyes. In conclusion, our findings indicate that optic neuritis is associated with a more significant RPC vessel density drop in NMOSD than in MS patients, and the predilection to superior and inferior sectors may be useful as a differential diagnostic marker.

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Quantification of Retinal Neural Loss in Patients with Neuromyelitis Optica and Multiple Sclerosis with or without Optic Neuritis Using Fourier-Domain Optical Coherence Tomography

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.11-9324 ◽

2012 ◽

Vol 53 (7) ◽

pp. 3959 ◽

Cited By ~ 60

Author(s):

Mário L. R. Monteiro ◽

Danilo B. Fernandes ◽

Samira L. Apóstolos-Pereira ◽

Dagoberto Callegaro

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Fourier Domain ◽

Optical Coherence

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A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458515578888 ◽

2015 ◽

Vol 21 (14) ◽

pp. 1781-1793 ◽

Cited By ~ 33

Author(s):

Olivier Outteryck ◽

Bilal Majed ◽

Sabine Defoort-Dhellemmes ◽

Patrick Vermersch ◽

Hélène Zéphir

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Ganglion Cell ◽

Neuromyelitis Optica ◽

Spectrum Disorder ◽

Imaging Biomarkers ◽

Ganglion Cell Complex ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder

Objectives: The aim of this study was to find, using spectral domain-optical coherence tomography (SD-OCT), retinal imaging biomarkers differentiating neuromyelitis optica spectrum disorder (NMOSD), multiple sclerosis (MS) and healthy controls (HCs). Materials and methods: The population was composed of patients with NMOSD ( n=23) or MS ( n=110) and of HCs ( n=75). Evaluation criteria were retinal thickness/volume, visual acuity, low contrast vision acuity and Expanded Disability Status Scale score. Results: Considering all eyes and after statistical adjustments including the number of optic neuritis (ON) episodes, we found that NMOSD patients did not have significantly more retinal atrophy than MS patients; whereas MS non-optic neuritis (NON) eyes had thinner temporal ( p=0.032) and temporo-superior peripapillary retinal nerve fibre layer (pRNFL; p=0.011) thicknesses than NMOSD NON eyes; in addition, NMOSD NON eyes presented significant naso-inferior pRNFL ( p=0.024), temporal pRNFL ( p=0.039), macular ganglion cell complex ( p=0.004) and ganglion cell layer ( p=0.002) atrophy vs HC eyes. We identified significant correlations between visual and clinical disability and retinal thicknesses in both diseases. Conclusion: OCT may help to differentiate NMOSD and MS by focusing on the NON eyes (temporal pRNFL atrophy more severe in MS). Moreover, we discuss the possibility of a retinal degenerative process independent of ON in NMOSD.

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Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography

Multiple Sclerosis Journal ◽

10.1177/1352458514567216 ◽

2015 ◽

Vol 21 (6) ◽

pp. 678-688 ◽

Cited By ~ 117

Author(s):

JL Bennett ◽

J de Seze ◽

M Lana-Peixoto ◽

J Palace ◽

A Waldman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Water Channel ◽

Optical Coherence ◽

Fiber Layer ◽

Specific Serum ◽

The Central Nervous System ◽

Inflammatory Autoimmune Disease

Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel aquaporin-4 present in up to 80% of NMO patients enables distinction from MS. Optic neuritis may occur in either condition resulting in neuro-anatomical retinal changes. Optical coherence tomography (OCT) has become a useful tool for analyzing retinal damage both in MS and NMO. Numerous studies showed that optic neuritis in NMO typically results in more severe retinal nerve fiber layer (RNFL) and ganglion cell layer thinning and more frequent development of microcystic macular edema than in MS. Furthermore, while patients’ RNFL thinning also occurs in the absence of optic neuritis in MS, subclinical damage seems to be rare in NMO. Thus, OCT might be useful in differentiating NMO from MS and serve as an outcome parameter in clinical studies.

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Optical coherence tomography angiography indicates associations of the retinal vascular network and disease activity in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458517750009 ◽

2018 ◽

Vol 25 (2) ◽

pp. 224-234 ◽

Cited By ~ 40

Author(s):

Nikolaus Feucht ◽

Mathias Maier ◽

Gildas Lepennetier ◽

Moritz Pettenkofer ◽

Carmen Wetzlmair ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Disease Activity ◽

Optical Coherence Tomography Angiography ◽

Retinal Layer ◽

Healthy Controls ◽

Optical Coherence ◽

History Of ◽

Vascular Plexuses

Background: Patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) may show alterations of retinal layer architecture as measured by optical coherence tomography. Little is known about changes in the retinal vascular network during MS. Objective: To characterize retinal vessel structures in patients with MS and CIS and to test for associations with MS disease activity. Method: In all, 42 patients with MS or CIS and 50 healthy controls underwent retinal optical coherence tomography angiography (OCT-A) with analysis of the superficial and deep vascular plexuses and the choriocapillaries. We tested OCT-A parameters for associations with retinal layer volumes, history of optic neuritis (ON), and the retrospective disease activity. Results: Inner retinal layer volumes correlated positively with the density of both the superficial and deep vascular plexuses. Eyes of MS/CIS patients with a history of ON revealed reduced vessel densities of the superficial and deep vascular plexuses as compared to healthy controls. Higher choriocapillary vessel densities were associated with ongoing inflammatory disease activity during 24 months prior to OCT-A examination in MS and CIS patients. Conclusion: Optic neuritis is associated with rarefaction of the superficial and deep retinal vessels. Alterations of the choriocapillaries might be linked to disease activity in MS.

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