scholarly journals MS optic neuritis-induced long-term structural changes within the visual pathway

2020 ◽  
Vol 7 (2) ◽  
pp. e665 ◽  
Author(s):  
Marc Pawlitzki ◽  
Marc Horbrügger ◽  
Kristian Loewe ◽  
Jörn Kaufmann ◽  
Roland Opfer ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Structural Damage ◽  
Structural Changes ◽  
Visual Pathway ◽  
System Structure ◽  
Pattern Reversal ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
History Of

BackgroundThe visual pathway is commonly involved in multiple sclerosis (MS), even in its early stages, including clinical episodes of optic neuritis (ON). The long-term structural damage within the visual compartment in patients with ON, however, is yet to be elucidated.ObjectiveOur aim was to characterize visual system structure abnormalities using MRI along with optical coherence tomography (OCT) and pattern-reversal visual evoked potentials (VEPs) depending on a single history of ON.MethodsTwenty-eight patients with clinically definitive MS, either with a history of a single ON (HON) or without such history and normal VEP findings (NON), were included. OCT measures comprised OCT-derived peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell/inner plexiform layer (GCIPL) thickness. Cortical and global gray and white matter, thalamic, and T2 lesion volumes were assessed using structural MRI. Diffusion-weighted MRI-derived measures included fractional anisotropy (FA), mean (MD), radial (RD), and axial (AD) diffusivity within the optic radiation (OR).ResultsMean (SD) duration after ON was 8.3 (3.7) years. Compared with the NON group, HON patients showed significant RNFL (p = 0.01) and GCIPL thinning (p = 0.002). OR FA (p = 0.014), MD (p = 0.005), RD (p = 0.007), and AD (p = 0.004) were altered compared with NON. Global gray and white as well as other regional gray matter structures did not differ between the 2 groups.ConclusionA single history of ON induces long-term structural damage within the retina and OR suggestive of both retrograde and anterograde neuroaxonal degeneration.

scholarly journals Bilateral retinal pathology following a first-ever clinical episode of autoimmune optic neuritis

2020 ◽  
Vol 7 (2) ◽  
pp. e671 ◽  
Author(s):  
Carla A. Wicki ◽  
Praveena Manogaran ◽  
Tanja Simic ◽  
James V.M. Hanson ◽  
Sven Schippling
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Structural Damage ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Low Contrast ◽  
Time Points ◽  
Acute Optic Neuritis ◽  
Retinal Pathology ◽  
Clinical Episode

ObjectiveThis longitudinal study aimed to assess changes in retinal structure and visual function following a first-ever episode of acute optic neuritis (ON).MethodsClinical and optical coherence tomography (OCT) data obtained over a period of 12 months were retrospectively analyzed in 41 patients with a first-ever clinical episode of acute ON. OCT scans, high-contrast visual acuity (HCVA), and low-contrast visual acuity (LCVA) were acquired at baseline and at 1, 3, 6, and 12 months thereafter. Macular ganglion cell and inner plexiform layer (GCIP), peripapillary retinal nerve fiber layer (pRNFL), and macular inner nuclear layer (INL) thicknesses were assessed by OCT. Linear mixed-effects models were used to analyze OCT variables of ipsilateral ON and contralateral non-ON (NON) eyes over time.ResultsThe mean change of GCIP thickness in ON eyes was significant at all follow-up time points, with nearly 75% of the total reduction having occurred by month 1. In ON eyes, thinner GCIP thickness at month 1 correlated with lower LCVA at month 3. Mean pRNFL thickness in ON eyes differed significantly from NON eyes at all postbaseline time points. INL thickness was significantly increased in ON eyes (month 1) but also in contralateral NON eyes (month 12).ConclusionsRetinal structural damage develops rapidly following acute ON and is associated with subsequent functional visual deficits. Our results also suggest bilateral retinal pathology following unilateral ON, possibly caused by subclinical involvement of the contralateral NON eyes. Moreover, our data may assist in clinical trial planning in studies targeting tissue damage in acute ON.

Visual field loss and structure–function relationships in optic neuritis associated with myelin oligodendrocyte glycoprotein antibody

2020 ◽  
pp. 135245852093728
Author(s):  
Romain Deschamps ◽  
Manon Philibert ◽  
Cedric Lamirel ◽  
Jerome Lambert ◽  
Vivien Vasseur ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Neuritis ◽  
Structural Damage ◽  
Structural Changes ◽  
Visual Field Loss ◽  
Visual Outcome ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Mean Deviation ◽  
Ophthalmological Examination ◽  
Fiber Layer

Background: A paradoxical discrepancy between severe peripapillary retinal nerve fiber layer (pRNFL) atrophy and good visual outcome had been reported in patients with myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG)-associated optic neuritis (ON). However, only visual acuity (VA) was assessed. Objectives: To study visual field (VF) outcomes of patients with MOG-IgG-associated ON and evaluate the correlation between functional eye outcome and retinal structural changes assessed by optical coherence tomography. Methods: The records of 32 patients with MOG-IgG-associated ON who underwent ophthalmological examination at least 12 months after ON onset were reviewed. Degree of VF disability was determined by mean deviation (MD). Results: At final assessment (median, 35 months), 4.2% of 48 affected eyes (AE) had VA ⩽ 0.1, 40% had abnormal MD, and among AE with final VA ⩾ 1.0, 31% had mild to moderate damage. Thinning of the inner retinal layers was significantly correlated with MD impairment. Analysis demonstrated a threshold of pRNFL thickness (50 µm), below which MD was significantly worse (mean, −2.27 dB vs −17.72 dB; p = 0.0003). ON relapse was significantly associated with poor visual outcome assessed by MD. Conclusion: Functional impairment measured with VF is not rare, and MD assessment better reflects actual structural damage.

scholarly journals Natural history of the anterior visual pathway after surgical decompression in patients with pituitary tumors

2015 ◽  
Vol 42 (S1) ◽  
pp. S45-S45 ◽  
Author(s):  
RA Won Hyung ◽  
W Chan ◽  
Y Starreveld ◽  
F Costello
Keyword(s):  
Structural Changes ◽  
Tumor Resection ◽  
Pituitary Tumors ◽  
Visual Pathway ◽  
Surgical Decompression ◽  
Fiber Layer ◽  
Nerve Fiber Layer Thickness ◽  
Compressive Neuropathy ◽  
History Of ◽  
Endoscopic Tumor Resection

Introduction: Visual dysfunction is one of the primary indications for surgical management of pituitary tumors with the goal of terminating the progressive decline in vision. Unfortunately, it is difficult to predict how successful surgical decompression will be in these patients. The purpose of this study was to assess the structural changes seen in the anterior visual pathway after pituitary tumor resection. Methods: 13 patients (7F) underwent endoscopic tumor resection for pituitary macroadenoma. Each patient underwent a full ophthalmologic assessment including optical coherence tomography (OCT) preoperatively and postoperatively at 3-6months and 9-12months. Post-surgical changes in the retinal nerve fiber layer thickness (RNFLT) for each eye (N=26) were compared in cases with normal preoperative RNFLT (greater than 80 μm) versus those with abnormally thinned RNFLT (less than 80 μm). Results: For 9 cases with thinned RNFLT preoperatively (mean=70.1 μm±8.5), there was a significant decline in RNFLT at 3-6 months follow-up (mean change= −3.8 μm;p=0.002), which did not recover even at 9-12months after surgery (mean=67.6 μm±12.7). Contrastingly, eyes with normal RNFLT preoperatively (mean=89.7 μm±9.4) did not show significant postoperative thinning (mean change= −1.9 μm). Conclusion: Even after a complete surgical decompression, there are ongoing structural changes in the anterior visual pathway in patients with compressive neuropathy. There may be a point of no return where surgical decompression may not prevent further structural degeneration.

scholarly journals Optical coherence tomography and visual evoked potentials in pediatric MS

2017 ◽  
Vol 4 (4) ◽  
pp. e356 ◽  
Author(s):  
Amy T. Waldman ◽  
Grant T. Liu ◽  
Amy M. Lavery ◽  
Geraldine Liu ◽  
William Gaetz ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Evoked Potentials ◽  
Visual Evoked Potentials ◽  
Visual Pathway ◽  
Pattern Reversal ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
History Of ◽  
Pediatric Onset ◽  
Visual Evoked

Objective:To determine the relative ability of optical coherence tomography (OCT) and pattern-reversal visual evoked potentials (pVEPs) to detect visual pathway involvement in pediatric-onset MS.Methods:Pediatric-onset MS participants (onset <18 years) and healthy controls (HCs) underwent OCT (Cirrus HD-OCT) and pVEPs. Retinal nerve fiber layer (RNFL), ganglion cell layer to inner plexiform layer (GCL-IPL), and P100 pVEP latency were measured. Generalized estimating equation models were used to compare the groups, adjusting for age and intereye correlations.Results:Twenty-four pediatric MS participants, 14 with a history of remote (>6 months) optic neuritis (ON) in one eye (8 participants) or both the eyes (6 participants), and 24 HCs were enrolled. RNFL thinning (<83 μm, 2 SDs below HC eyes) occurred in 50% of ON eyes vs 5% of non-ON eyes. Prolonged VEP latency (>109 msec) occurred in 58% of ON eyes and 55% of non-ON eyes. A clinical history of ON predicted RNFL (p < 0.001) and GCL-IPL thinning (p = 0.011), whereas prolonged pVEP latency in children with MS occurred independent of ON history.Conclusions:OCT and pVEPs provide complementary but distinct insights. OCT is sensitive to retinal changes in the context of clinical ON, whereas pVEPs are useful to detect disseminated lesions of the visual pathway in children with MS.

scholarly journals Age-dependent favorable visual recovery despite significant retinal atrophy in pediatric MOGAD: how much retina do you really need to see well?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Joachim Havla ◽  
Thivya Pakeerathan ◽  
Carolin Schwake ◽  
Jeffrey L. Bennett ◽  
Ingo Kleiter ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Structural Damage ◽  
Structural Changes ◽  
Inner Plexiform Layer ◽  
Visual Recovery ◽  
Fiber Layer ◽  
Initial Manifestation ◽  
Low Contrast ◽  
Age Related ◽  
Retinal Atrophy

Abstract Background To investigate age-related severity, patterns of retinal structural damage, and functional visual recovery in pediatric and adult cohorts of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) optic neuritis (ON). Methods All MOGAD patients from the 5 participating centers were included. Patients with initial manifestation <18 years were included in the pediatric (MOGADped) cohort and patients with ≥18 years in the adult (MOGADadult) cohort. For patients with MOGAD ON, examinations at least ≥6 months after ON onset were included in the analyses. Using spectral domain optical coherence tomography (SD-OCT), we acquired peripapillary retinal nerve fiber layer thickness (pRNFL) and volumes of combined ganglion cell and inner plexiform layer (GCIPL). High- and 2.5% low-contrast visual acuity (HCVA, LCVA) and visual-evoked potentials (VEP) were obtained. Results Twenty MOGADped (10.3±3.7 years, 30 MOGAD ON eyes) and 39 MOGADadult (34.9±11.6 years, 42 MOGAD ON eyes) patients were included. The average number of ON episodes per ON eye was similar in both groups (1.8±1.3 and 2.0±1.7). In both pediatric and adult MOGAD, ON led to pronounced neuroaxonal retinal atrophy (pRNFL: 63.1±18.7 and 64.3±22.9 μm; GCIPL: 0.42±0.09 and 0.44±0.13 mm3, respectively) and moderate delay of the VEP latencies (117.9±10.7 and 118.0±14.5 ms). In contrast, visual acuity was substantially better in children (HCVA: 51.4±9.3 vs. 35.0±20.6 raw letters, p=0.001; LCVA: 22.8±14.6 vs. 13.5±16.4, p=0.028). Complete visual recovery (HCVA-logMAR 0.0) occurred in 73.3% of MOGADped and 31% MOGADadults ON eyes, while 3.3% and 31% demonstrated moderate to severe (logMAR > 0.5) visual impairment. Independent of retinal atrophy, age at ON onset significantly correlated with visual outcome. Conclusion Pediatric MOGAD ON showed better visual recovery than adult MOGAD ON despite profound and almost identical neuroaxonal retinal atrophy. Age-related cortical neuroplasticity may account for the substantial discrepancy between structural changes and functional outcomes.

scholarly journals Evidence of subclinical quantitative retinal layer abnormalities in AQP4-IgG seropositive NMOSD

2020 ◽  
pp. 135245852097777
Author(s):  
Angeliki G Filippatou ◽  
Eleni S Vasileiou ◽  
Yufan He ◽  
Kathryn C Fitzgerald ◽  
Grigorios Kalaitzidis ◽  
...  
Keyword(s):  
Ganglion Cell ◽  
Outer Nuclear Layer ◽  
Sensitivity Analyses ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Foveal Thickness ◽  
Cross Sectional ◽  
Photoreceptor Layer ◽  
History Of

Background: Prior studies have suggested that subclinical retinal abnormalities may be present in aquaporin-4 immunoglobulin G (AQP4-IgG) seropositive neuromyelitis optica spectrum disorder (NMOSD), in the absence of a clinical history of optic neuritis (ON). Objective: Our aim was to compare retinal layer thicknesses at the fovea and surrounding macula between AQP4-IgG+ NMOSD eyes without a history of ON (AQP4-nonON) and healthy controls (HC). Methods: In this single-center cross-sectional study, 83 AQP4-nonON and 154 HC eyes were studied with spectral-domain optical coherence tomography (OCT). Results: Total foveal thickness did not differ between AQP4-nonON and HC eyes. AQP4-nonON eyes exhibited lower outer nuclear layer (ONL) and inner photoreceptor segment (IS) thickness at the fovea (ONL: −4.01 ± 2.03 μm, p = 0.049; IS: −0.32 ± 0.14 μm, p = 0.029) and surrounding macula (ONL: −1.98 ± 0.95 μm, p = 0.037; IS: −0.16 ± 0.07 μm, p = 0.023), compared to HC. Macular retinal nerve fiber layer (RNFL: −1.34 ± 0.51 μm, p = 0.009) and ganglion cell + inner plexiform layer (GCIPL: −2.44 ± 0.93 μm, p = 0.009) thicknesses were also lower in AQP4-nonON compared to HC eyes. Results were similar in sensitivity analyses restricted to AQP4-IgG+ patients who had never experienced ON in either eye. Conclusions: AQP4-nonON eyes exhibit evidence of subclinical retinal ganglion cell neuronal and axonal loss, as well as structural evidence of photoreceptor layer involvement. These findings support that subclinical anterior visual pathway involvement may occur in AQP4-IgG+ NMOSD.

scholarly journals Retinal Oxygen Metabolism and Haemodynamics in Patients With Multiple Sclerosis and History of Optic Neuritis

2021 ◽  
Vol 15 ◽  
Author(s):  
Martin Kallab ◽  
Nikolaus Hommer ◽  
Andreas Schlatter ◽  
Gabriel Bsteh ◽  
Patrick Altmann ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optical Coherence Tomography ◽  
Optic Neuritis ◽  
Layer Thickness ◽  
Oxygen Metabolism ◽  
Retinal Blood Flow ◽  
Oxygen Extraction ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
History Of

Vascular changes and alterations of oxygen metabolism are suggested to be implicated in multiple sclerosis (MS) pathogenesis and progression. Recently developed in vivo retinal fundus imaging technologies provide now an opportunity to non-invasively assess metabolic changes in the neural retina. This study was performed to assess retinal oxygen metabolism, peripapillary capillary density (CD), large vessel density (LVD), retinal nerve fiber layer thickness (RNFLT) and ganglion cell inner plexiform layer thickness (GCIPLT) in patients with diagnosed relapsing multiple sclerosis (RMS) and history of unilateral optic neuritis (ON). 16 RMS patients and 18 healthy controls (HC) were included in this study. Retinal oxygen extraction was modeled using O2 saturations and Doppler optical coherence tomography (DOCT) derived retinal blood flow (RBF) data. CD and LVD were assessed using optical coherence tomography (OCT) angiography. RNFLT and GCIPLT were measured using structural OCT. Measurements were performed in eyes with (MS+ON) and without (MS-ON) history for ON in RMS patients and in one eye in HC. Total oxygen extraction was lowest in MS+ON (1.8 ± 0.2 μl O2/min), higher in MS-ON (2.1 ± 0.5 μl O2/min, p = 0.019 vs. MS+ON) and highest in HC eyes (2.3 ± 0.6 μl O2/min, p = 0.002 vs. MS, ANOVA p = 0.031). RBF was lower in MS+ON (33.2 ± 6.0 μl/min) compared to MS-ON (38.3 ± 4.6 μl/min, p = 0.005 vs. MS+ON) and HC eyes (37.2 ± 4.7 μl/min, p = 0.014 vs. MS+ON, ANOVA p = 0.010). CD, LVD, RNFLT and GCIPL were significantly lower in MS+ON eyes. The present data suggest that structural alterations in the retina of RMS patients are accompanied by changes in oxygen metabolism, which are more pronounced in MS+ON than in MS-ON eyes. Whether these alterations promote MS onset and progression or occur as consequence of disease warrants further investigation.Clinical Trial Registration:ClinicalTrials.gov registry, NCT03401879.

scholarly journals Optical Coherence Tomography and Optical Coherence Tomography Angiography Findings After Optic Neuritis in Multiple Sclerosis

2020 ◽  
Vol 11 ◽  
Author(s):  
Olwen C. Murphy ◽  
Grigorios Kalaitzidis ◽  
Eleni Vasileiou ◽  
Angeliki G. Filippatou ◽  
Jeffrey Lambe ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optical Coherence Tomography ◽  
Optic Neuritis ◽  
Visual Function ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Retinal Microvasculature ◽  
History Of

Background: In people with multiple sclerosis (MS), optic neuritis (ON) results in inner retinal layer thinning, and reduced density of the retinal microvasculature.Objective: To compare inter-eye differences (IEDs) in macular optical coherence tomography (OCT) and OCT angiography (OCTA) measures in MS patients with a history of unilateral ON (MS ON) vs. MS patients with no history of ON (MS non-ON), and to assess how these measures correlate with visual function outcomes after ON.Methods: In this cross-sectional study, people with MS underwent OCT and OCTA. Superficial vascular plexus (SVP) density of each eye was quantified using a deep neural network. IEDs were calculated with respect to the ON eye in MS ON patients, and with respect to the right eye in MS non-ON patients. Statistical analyses used mixed-effect regression models accounting for intra-subject correlations.Results: We included 43 MS ON patients (with 92 discrete OCT/OCTA visits) and 14 MS non-ON patients (with 24 OCT/OCTA visits). Across the cohorts, mean IED in SVP density was −2.69% (SD 3.23) in MS ON patients, as compared to 0.17% (SD 2.39) in MS non-ON patients (p = 0.002). When the MS ON patients were further stratified according to time from ON and compared to MS non-ON patients with multiple cross-sectional analyses, we identified that IED in SVP density was significantly increased in MS ON patients at 1–3 years (p = &lt; 0.001) and &gt;3 years post-ON (p &lt; 0.001), but not at &lt;3 months (p = 0.21) or 3–12 months post-ON (p = 0.07), while IED in ganglion cell + inner plexiform layer (GCIPL) thickness was significantly increased in MS ON patients at all time points post-ON (p ≦ 0.01 for all). IED in SVP density and IED in GCIPL thickness demonstrated significant relationships with IEDs in 100% contrast, 2.5% contrast, and 1.25% contrast letter acuity in MS ON patients (p &lt; 0.001 for all).Conclusions: Our findings suggest that increased IED in SVP density can be detected after ON in MS using OCTA, and detectable changes in SVP density after ON may occur after changes in GCIPL thickness. IED in SVP density and IED in GCIPL thickness correlate well with visual function outcomes in MS ON patients.

scholarly journals OCT based evaluation of retinal changes in multiple sclerosis

2017 ◽  
Vol 5 (9) ◽  
pp. 4117
Author(s):  
Sonal Singh ◽  
Rishi Sharma ◽  
V. S. Gurunadh ◽  
Sandeep Shankar
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Retinal Nerve Fibre Layer ◽  
Macular Thickness ◽  
Prior History ◽  
P Value ◽  
Central Macular Thickness ◽  
Fiber Layer ◽  
History Of ◽  
Age And Sex

Background: Optical coherence tomography is a non-invasive imaging technique routinely used in ophthalmology to visualize and quantify the layers of the retina. It also provides information on optic nerve head topography, peripapillary retinal nerve fibre layer thickness and macular volume which correlate with axonal loss. These measurements are of interest in optic neuropathies and in multiple sclerosis. The OCT parameters are now used as endpoints in neurologic clinical trials.Methods: A prospective study involving 30 patients of multiple sclerosis and equal number of age and sex matched controls were subjected to evaluation of retinal changes (peripapillary retinal nerve fiber layer and central macular thickness) using Zeiss Cirrus HD-OCT machine. The results collected were then subjected to statistical analysis.Results: Significant RNFL thinning was seen in patients of multiple sclerosis compared to the age and sex matched controls. Marked thinning was seen in superior and temporal quadrants of right eye (p value of 0.002 and 0.008 respectively) and all quadrants in left eye with a p value of < 0.001. Patients with multiple sclerosis for more than 5 yrs showed statistically significant RNFL thinning in the superior quadrant of right eye (p<.005), however, no such changes were seen in rest of the quadrants of right eye and in none of the quadrants of left eye Significant RNFL thinning was seen in the patients of multiple sclerosis without prior history of optic neuritis than patients with prior history of optic neuritis which was statistically significant with p value of .001.Conclusions: Patients with multiple sclerosis for more than 5 yrs showed statistically significant RNFL thinning in the superior quadrant of right eye (p<.005). Significant RNFL thinning was seen in the patients of multiple sclerosis without prior history of optic neuritis than patients with prior history of Optic neuritis which was statistically significant with p value of .001. No significant changes were seen in central macular thickness in multiple sclerosis compared to the controls which was corroborated by statistical analysis (p value of 0.37).

Sign in / Sign up

Export Citation Format

Share Document