Sex-specific differences in retinal nerve fiber layer thinning after acute optic neuritis

Background Lipoic acid, an antioxidant, has beneficial effects in experimental acute optic neuritis and autoimmune encephalomyelitis. Optical coherence tomography can detect retinal nerve fiber layer thinning, representing axonal degeneration, approximately 3–6 months after acute optic neuritis. Objective To determine whether lipoic acid is neuroprotective in acute optic neuritis. Methods A single-center, double-blind, randomized, placebo controlled, 24-week trial. Intervention included 6 weeks of once daily lipoic acid (1200 mg) or placebo within 14 days of acute optic neuritis diagnosis. The primary outcome was the mean difference in affected eye retinal nerve fiber layer (RNFL) thickness from baseline to 24 weeks. Results We enrolled 31 subjects (placebo n=16; lipoic acid n=15; average age 38.6 years (standard deviation (SD) 10.3)). Affected eye mean global RNFL thickness (µm) in the lipoic acid group decreased from 108.47 (SD 26.11) at baseline to 79.31 (SD 19.26) at 24 weeks. The affected eye RNFL in the placebo group decreased from 103.67 (SD 18.04) at baseline to 84.43 (SD 20.94) at 24 weeks. Unaffected eye RNFL thickness did not significantly change in either group over 24 weeks. Conclusion Six weeks of oral lipoic acid supplementation after acute optic neuritis is safe and well tolerated; however, because of insufficient recruitment, we could not conclude that lipoic acid treatment was neuroprotective in acute optic neuritis.

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Baseline, one and three month changes in the peripapillary retinal nerve fiber layer in acute optic neuritis: Relation to baseline vision and MRI

Journal of the Neurological Sciences ◽

10.1016/j.jns.2011.05.039 ◽

2011 ◽

Vol 308 (1-2) ◽

pp. 117-123 ◽

Cited By ~ 35

Author(s):

Mark J. Kupersmith ◽

Gary Mandel ◽

Susan Anderson ◽

Daniel E. Meltzer ◽

Randy Kardon

Keyword(s):

Optic Neuritis ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Acute Optic Neuritis ◽

Retinal Nerve Fiber

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Predictive value of 1 month retinal nerve fiber layer thinning for deficits at 6 months after acute optic neuritis

Multiple Sclerosis Journal ◽

10.1177/1352458513485149 ◽

2013 ◽

Vol 19 (13) ◽

pp. 1743-1748 ◽

Cited By ~ 13

Author(s):

Mark J Kupersmith ◽

Susan Anderson ◽

Randy Kardon

Keyword(s):

Optic Neuritis ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Vision Loss ◽

Threshold Field ◽

Mean Deviation ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Acute Optic Neuritis ◽

Retinal Nerve Fiber

Background: Retinal nerve fiber layer (RNFL) loss occurs with multiple sclerosis and after optic neuritis. Vision or RNFL changes at presentation of optic neuritis are not predictive of outcome, but vision loss at 1 month correlates with vision deficits at 6 months. We hypothesized that RFNL thinning at 1 month would predict RNFL loss at 6 months. Methods: We prospectively studied the RNFL by optical coherence tomography (OCT) and scanning laser polarimetry (SLP), and determined the threshold field mean deviation, in 25 subjects with acute optic neuritis over a 6-month period. RNFL values, including the amount of thinning at 1-month, were correlated with 6-month outcome. Results: Baseline visual performance and RNFL values were similar for eyes grouped by 1 month RNFL thinning. Eyes with 1 month RNFL thinning had greater and significant RNFL thinning at 6 months, for all quadrants by OCT and for the nasal and inferior quadrants by SLP. RNFL thinning by OCT and SLP at 1 month correlated with 6-month OCT ( r = 0.58; p = 0.006) and SLP ( r = 0.59; p = 0.002) RNFL thinning, respectively. Conclusion: Early RNFL loss at 1 month was predictive of the RNFL thinning at 6 months, which corroborated the importance of the 1-month time point for predicting the outcome of an optic neuritis attack.

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Exploring the Association between Retinal Nerve Fiber Layer Thickness and Initial Magnetic Resonance Imaging Findings in Patients with Acute Optic Neuritis

Multiple Sclerosis International ◽

10.1155/2011/289785 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Fiona Costello ◽

William Hodge ◽

Y. Irene Pan

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Optic Neuritis ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Resonance Imaging ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Acute Optic Neuritis ◽

Retinal Nerve Fiber

Background. Recent studies have shown that OCT-measured retinal nerve fiber layer (RNFL) values may represent a marker for axonal damage in the anterior visual pathway of optic neuritis (ON) and multiple sclerosis (MS) patients. The goal of this study was to determine the link between RNFL values and initial magnetic resonance imaging (MRI) evidence of central nervous system (CNS) inflammation in patients with acute ON.Methods. Fifty patients who experienced ON as a clinically isolated syndrome (CIS) were followed for a mean period of 34 months with OCT testing. RNFL values in affected (ON) eyes and clinically unaffected (non-ON) eyes were compared between patients with MRI evidence of white matter lesions and those with normal baseline MRI findings, over a two year period.Findings. Twenty-one patients (42%) developed clinically definite MS (CDMS) during the study. After two years, temporal RNFL values were thinner (P=.07) in ON patients with MRI lesions at baseline, but the results were not significant.Conclusions. There is no association between RNFL values and baseline MRI status in ON patients at risk for future CDMS over a two year period.

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Imaging of the optic disc and retinal nerve fiber layer in acute optic neuritis

Journal of the Neurological Sciences ◽

10.1016/j.jns.2006.08.012 ◽

2006 ◽

Vol 250 (1-2) ◽

pp. 114-119 ◽

Cited By ~ 46

Author(s):

Michael J. Pro ◽

Mauricio E. Pons ◽

Jeffrey M. Liebmann ◽

Robert Ritch ◽

Samiah Zafar ◽

...

Keyword(s):

Optic Neuritis ◽

Nerve Fiber ◽

Optic Disc ◽

Retinal Nerve Fiber Layer ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Acute Optic Neuritis ◽

Retinal Nerve Fiber

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Retinal nerve fiber layer thickness is associated with lesion length in acute optic neuritis

Neurology ◽

10.1212/wnl.0b013e3181ca0135 ◽

2010 ◽

Vol 74 (3) ◽

pp. 252-258 ◽

Cited By ~ 13

Author(s):

K. Kallenbach ◽

H. Simonsen ◽

B. Sander ◽

B. Wanscher ◽

H. Larsson ◽

...

Keyword(s):

Optic Neuritis ◽

Nerve Fiber ◽

Layer Thickness ◽

Retinal Nerve Fiber Layer ◽

Lesion Length ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Nerve Fiber Layer Thickness ◽

Acute Optic Neuritis ◽

Retinal Nerve Fiber

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Tracking retinal nerve fiber layer loss after optic neuritis: a prospective study using optical coherence tomography

Multiple Sclerosis Journal ◽

10.1177/1352458508091367 ◽

2008 ◽

Vol 14 (7) ◽

pp. 893-905 ◽

Cited By ~ 126

Author(s):

F Costello ◽

W Hodge ◽

YI Pan ◽

E Eggenberger ◽

S Coupland ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optic Neuritis ◽

Nerve Fiber ◽

Layer Thickness ◽

Retinal Nerve Fiber Layer ◽

Optical Coherence ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Nerve Fiber Layer Thickness ◽

Retinal Nerve Fiber

Introduction Optic neuritis causes retinal nerve fiber layer damage, which can be quantified with optical coherence tomography. Optical coherence tomography may be used to track nerve fiber layer changes and to establish a time-dependent relationship between retinal nerve fiber layer thickness and visual function after optic neuritis. Methods This prospective case series included 78 patients with optic neuritis, who underwent optical coherence tomography and visual testing over a mean period of 28 months. The main outcome measures included comparing inter-eye differences in retinal nerve fiber layer thickness between clinically affected and non-affected eyes over time; establishing when RNFL thinning stabilized after optic neuritis; and correlating retinal nerve fiber layer thickness and visual function. Results The earliest significant inter-eye differences manifested 2-months after optic neuritis, in the temporal retinal nerve fiber layer. Inter-eye comparisons revealed significant retinal nerve fiber layer thinning in clinically affected eyes, which persisted for greater than 24 months. Retinal nerve fiber thinning manifested within 6 months and then stabilized from 7 to 12 months after optic neuritis. Regression analyses demonstrated a threshold of nerve fiber layer thickness (75μm), which predicted visual recovery after optic neuritis. Conclusions Retinal nerve fiber layer changes may be tracked and correlated with visual function within 12 months of an optic neuritis event.

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Three-Dimensional Geometries Representing the Retinal Nerve Fiber Layer in Multiple Sclerosis, Optic Neuritis, and Healthy Eyes

Ophthalmic Research ◽

10.1159/000350413 ◽

2013 ◽

Vol 50 (1) ◽

pp. 72-81 ◽

Cited By ~ 3

Author(s):

Elena Garcia-Martin ◽

Begoña Calvo ◽

Mauro Malvè ◽

Raquel Herrero ◽

Isabel Fuertes ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Three Dimensional ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Healthy Eyes ◽

Retinal Nerve Fiber

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Axonal loss in the retinal nerve fiber layer in patients with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458507087326 ◽

2008 ◽

Vol 14 (5) ◽

pp. 609-614 ◽

Cited By ~ 88

Author(s):

V Pueyo ◽

J Martin ◽

J Fernandez ◽

C Almarcegui ◽

J Ara ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Axonal Loss ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Rnfl Thickness ◽

Healthy Eyes ◽

Retinal Nerve Fiber

Objective To quantify axonal loss in the retinal nerve fiber layer (RNFL) in patients with multiple sclerosis (MS), with and without a history of optic neuritis, by means of ocular imaging technologies. Methods This cross-sectional study enrolled 50 patients with MS and 25 age- and sex-matched healthy controls. All patients underwent neurologic assessment and a complete ophthalmic examination that included visual acuity, visual field examination, optical coherence tomography (OCT), scanning laser polarimetry (GDx) and visual evoked potentials (VEPs). Visual parameters and RNFL measurements were evaluated in MS eyes with a prior optic neuritis episode (MS-ON), with no prior episode (MS-NON) and control subjects. Results There were significant differences ( p < 0.05, analysis of variance) between MS-ON ( n = 25 eyes) and healthy eyes ( n = 25 eyes) for all RNFL parameters measured by OCT and GDx. Significant differences between MS-NON ( n = 75 eyes) and healthy eyes were also found for most of these parameters. RNFL thickness in the temporal quadrant was the parameter with the greatest differences between groups (71.79 μm in healthy eyes, 60.29 μm in MS-NON and 53.92 μm in MS-ON, p < 0.0005). Although there was a highly significant but moderate correlation between RNFL thickness and duration of the disease, no correlation was observed between RNFL thickness and neurologic impairment (Expanded Disability Status Scale). Conclusions Axonal loss was detected not only in MS eyes with a previous acute optic neuritis, but also in MS eyes with no known optic neuritis episode. Structural abnormalities correlate with functional assessments of the optic nerve.

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