Optical Coherence Tomography of First-Ever Optic Neuritis Helps Differentiate Neuromyelitis Optica Spectrum Disorder from Multiple Sclerosis

2016 ◽  
Vol 03 (04) ◽  
Author(s):  
Young Joo Shin
2021 ◽  
Vol 10 (4) ◽  
pp. 609
Author(s):  
Małgorzata Rogaczewska ◽  
Sławomir Michalak ◽  
Marcin Stopa

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.


2015 ◽  
Vol 21 (14) ◽  
pp. 1781-1793 ◽  
Author(s):  
Olivier Outteryck ◽  
Bilal Majed ◽  
Sabine Defoort-Dhellemmes ◽  
Patrick Vermersch ◽  
Hélène Zéphir

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.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253417
Author(s):  
Małgorzata Rogaczewska ◽  
Sławomir Michalak ◽  
Marcin Stopa

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS+ON and MS-ON eyes compared to healthy eyes. In NMOSD+ON and NMOSD-ON, the DCP did not remarkably differ from the control group. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS+ON, MS-ON, and NMOSD+ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to ganglion cells’ atrophy, while vasculopathy seems to be a primary process in NMOSD patients.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Małgorzata Rogaczewska ◽  
Sławomir Michalak ◽  
Marcin Stopa

AbstractNeuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are autoimmune demyelinating diseases of distinct etiology presenting with optic neuritis (ON). This study aimed to identify the macular and peripapillary neurovascular alterations that may facilitate the differentiation between NMOSD and MS eyes using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA). A total of 13 NMOSD patients and 40 MS patients were evaluated. After ON, the radial peripapillary capillary (RPC) vessel density was significantly decreased in the superior (S) and inferior (I) sectors in NMOSD compared with MS eyes, whereas in non-ON eyes, the temporal (T) sector of RPC was reduced in MS group. In the ON eyes, the retinal nerve fiber layer in the I and T quadrants was thinner in NMOSD than in MS. Regarding ON and non-ON eyes, the macular capillary plexuses, and the ganglion cell complex thickness did not differ between NMOSD and MS. The ratios, based on the disease-specific intra-eye RPC vessel density reduction pattern, were the best discriminants between NMOSD and MS, i.e., inferior to nasal (I/N) and I/T ratios for ON eyes, and S/T and N/T ratios for non-ON eyes. Our results show that the OCTA-based simple ratios may be useful in distinguishing NMOSD and MS patients.


2020 ◽  
Author(s):  
Małgorzata Rogaczewska ◽  
Sławomir Michalak ◽  
Marcin Stopa

Abstract Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls by using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS + ON, NMOSD + ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS + ON, and MS-ON eyes compared to healthy eyes and decreased in NMOSD + ON compared to MS + ON. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS + ON, MS-ON, and NMOSD + ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to the reduced metabolic demand of the atrophied ganglion cell layer, while the vasculopathy seems to be a primary process in NMOSD patients.


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