Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning

John N. Ratchford, Shiv Saidha, Elias S. Sotirchos, Jiwon A. Oh, Michaela A. Seigo, Christopher Eckstein, Mary K. Durbin, Jonathan D. Oakley, Scott A. Meyer, Amy Conger, Teresa C. Frohman, Scott D. Newsome, Laura J. Balcer, Elliot Frohman, Peter A. Calabresi

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Abstract

Objective: To determine the effect of clinical and radiologic disease activity on the rate of thinning of the ganglion cell/inner plexiform (GCIP) layer and the retinal nerve fiber layer in patients with multiple sclerosis (MS) using optical coherence tomography (OCT). Methods: One hundred sixty-four patients with MS and 59 healthy controls underwent spectraldomain OCT scans every 6 months for a mean follow-up period of 21.1 months. Baseline and annual contrast-enhanced brain MRIs were performed. Patients who developed optic neuritis during follow-up were excluded from analysis. Results: Patients with the following features of disease activity during follow-up had faster rates of annualized GCIP thinning: relapses (42% faster, p = 0.007), new gadolinium-enhancing lesions (54% faster, p < 0.001), and new T2 lesions (36% faster, p = 0.02). Annual GCIP thinning was 37% faster in those with disability progression during follow-up, and 43% faster in those with disease duration <5 years vs >5 years (p = 0.003). Annual rates of GCIP thinning were highest in patients exhibiting combinations of new gadolinium-enhancing lesions, new T2 lesions, and disease duration <5 years (70% faster in patients with vs without all 3 characteristics, p < 0.001). Conclusions: MS patients with clinical and/or radiologic nonocular disease activity, particularly early in the disease course, exhibit accelerated GCIP thinning. Our findings suggest that retinal changes in MS reflect global CNS processes, and that OCT-derived GCIP thickness measures may have utility as an outcome measure for assessing neuroprotective agents, particularly in early, active MS.

Original languageEnglish (US)
Pages (from-to)47-54
Number of pages8
JournalNeurology
Volume80
Issue number1
DOIs
StatePublished - Jan 1 2013

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ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Ratchford, J. N., Saidha, S., Sotirchos, E. S., Oh, J. A., Seigo, M. A., Eckstein, C., Durbin, M. K., Oakley, J. D., Meyer, S. A., Conger, A., Frohman, T. C., Newsome, S. D., Balcer, L. J., Frohman, E., & Calabresi, P. A. (2013). Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning. Neurology, 80(1), 47-54. https://doi.org/10.1212/WNL.0b013e31827b1a1c