Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis

Lauren S. Talman, Esther R. Bisker, David J. Sackel, David A. Long, Kristin M. Galetta, John N. Ratchford, Deacon J. Lile, Sheena K. Farrell, Michael J. Loguidice, Gina Remington, Amy Conger, Teresa C. Frohman, Dina A. Jacobs, Clyde E. Markowitz, Gary R. Cutter, Gui Shuang Ying, Yang Dai, Maureen G. Maguire, Steven L. Galetta, Elliot FrohmanPeter A. Calabresi, Laura J. Balcer

Research output: Contribution to journalArticle

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Abstract

Objective: Cross-sectional studies of optical coherence tomography (OCT) show that retinal nerve fiber layer (RNFL) thickness is reduced in multiple sclerosis (MS) and correlates with visual function. We determined how longitudinal changes in RNFL thickness relate to visual loss. We also examined patterns of RNFL thinning over time in MS eyes with and without a prior history of acute optic neuritis (ON). Methods: Patients underwent OCT measurement of RNFL thickness at baseline and at 6-month intervals during a mean follow-up of 18 months at 3 centers. Low-contrast letter acuity (2.5%, 1.25% contrast) and visual acuity (VA) were assessed. Results: Among 299 patients (593 eyes) with ≥6 months follow-up, eyes with visual loss showed greater RNFL thinning compared to eyes with stable vision (low-contrast acuity, 2.5%: p < 0.001; VA: p = 0.005). RNFL thinning increased over time, with average losses of 2.9μm at 2 to 3 years and 6.1μm at 3 to 4.5 years (p < 0.001 vs 0.5-1-year follow-up interval). These patterns were observed for eyes with or without prior history of ON. Proportions of eyes with RNFL loss greater than test-retest variability (≥6.6μm) increased from 11% at 0 to 1 year to 44% at 3 to 4.5 years (p < 0.001). Interpretation: Progressive RNFL thinning occurs as a function of time in some patients with MS, even in the absence of ON, and is associated with clinically significant visual loss. These findings are consistent with subclinical axonal loss in the anterior visual pathway in MS, and support the use of OCT and low-contrast acuity as methods to evaluate the effectiveness of putative neuroprotection protocols.

Original languageEnglish (US)
Pages (from-to)749-760
Number of pages12
JournalAnnals of Neurology
Volume67
Issue number6
DOIs
StatePublished - Jun 2010

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Nerve Fibers
Multiple Sclerosis
Longitudinal Studies
Optic Neuritis
Optical Coherence Tomography
Visual Acuity
Low Vision
Visual Pathways
Cross-Sectional Studies

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Talman, L. S., Bisker, E. R., Sackel, D. J., Long, D. A., Galetta, K. M., Ratchford, J. N., ... Balcer, L. J. (2010). Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. Annals of Neurology, 67(6), 749-760. https://doi.org/10.1002/ana.22005

Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. / Talman, Lauren S.; Bisker, Esther R.; Sackel, David J.; Long, David A.; Galetta, Kristin M.; Ratchford, John N.; Lile, Deacon J.; Farrell, Sheena K.; Loguidice, Michael J.; Remington, Gina; Conger, Amy; Frohman, Teresa C.; Jacobs, Dina A.; Markowitz, Clyde E.; Cutter, Gary R.; Ying, Gui Shuang; Dai, Yang; Maguire, Maureen G.; Galetta, Steven L.; Frohman, Elliot; Calabresi, Peter A.; Balcer, Laura J.

In: Annals of Neurology, Vol. 67, No. 6, 06.2010, p. 749-760.

Research output: Contribution to journalArticle

Talman, LS, Bisker, ER, Sackel, DJ, Long, DA, Galetta, KM, Ratchford, JN, Lile, DJ, Farrell, SK, Loguidice, MJ, Remington, G, Conger, A, Frohman, TC, Jacobs, DA, Markowitz, CE, Cutter, GR, Ying, GS, Dai, Y, Maguire, MG, Galetta, SL, Frohman, E, Calabresi, PA & Balcer, LJ 2010, 'Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis', Annals of Neurology, vol. 67, no. 6, pp. 749-760. https://doi.org/10.1002/ana.22005
Talman LS, Bisker ER, Sackel DJ, Long DA, Galetta KM, Ratchford JN et al. Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. Annals of Neurology. 2010 Jun;67(6):749-760. https://doi.org/10.1002/ana.22005
Talman, Lauren S. ; Bisker, Esther R. ; Sackel, David J. ; Long, David A. ; Galetta, Kristin M. ; Ratchford, John N. ; Lile, Deacon J. ; Farrell, Sheena K. ; Loguidice, Michael J. ; Remington, Gina ; Conger, Amy ; Frohman, Teresa C. ; Jacobs, Dina A. ; Markowitz, Clyde E. ; Cutter, Gary R. ; Ying, Gui Shuang ; Dai, Yang ; Maguire, Maureen G. ; Galetta, Steven L. ; Frohman, Elliot ; Calabresi, Peter A. ; Balcer, Laura J. / Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. In: Annals of Neurology. 2010 ; Vol. 67, No. 6. pp. 749-760.
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T1 - Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis

AU - Talman, Lauren S.

AU - Bisker, Esther R.

AU - Sackel, David J.

AU - Long, David A.

AU - Galetta, Kristin M.

AU - Ratchford, John N.

AU - Lile, Deacon J.

AU - Farrell, Sheena K.

AU - Loguidice, Michael J.

AU - Remington, Gina

AU - Conger, Amy

AU - Frohman, Teresa C.

AU - Jacobs, Dina A.

AU - Markowitz, Clyde E.

AU - Cutter, Gary R.

AU - Ying, Gui Shuang

AU - Dai, Yang

AU - Maguire, Maureen G.

AU - Galetta, Steven L.

AU - Frohman, Elliot

AU - Calabresi, Peter A.

AU - Balcer, Laura J.

PY - 2010/6

Y1 - 2010/6

N2 - Objective: Cross-sectional studies of optical coherence tomography (OCT) show that retinal nerve fiber layer (RNFL) thickness is reduced in multiple sclerosis (MS) and correlates with visual function. We determined how longitudinal changes in RNFL thickness relate to visual loss. We also examined patterns of RNFL thinning over time in MS eyes with and without a prior history of acute optic neuritis (ON). Methods: Patients underwent OCT measurement of RNFL thickness at baseline and at 6-month intervals during a mean follow-up of 18 months at 3 centers. Low-contrast letter acuity (2.5%, 1.25% contrast) and visual acuity (VA) were assessed. Results: Among 299 patients (593 eyes) with ≥6 months follow-up, eyes with visual loss showed greater RNFL thinning compared to eyes with stable vision (low-contrast acuity, 2.5%: p < 0.001; VA: p = 0.005). RNFL thinning increased over time, with average losses of 2.9μm at 2 to 3 years and 6.1μm at 3 to 4.5 years (p < 0.001 vs 0.5-1-year follow-up interval). These patterns were observed for eyes with or without prior history of ON. Proportions of eyes with RNFL loss greater than test-retest variability (≥6.6μm) increased from 11% at 0 to 1 year to 44% at 3 to 4.5 years (p < 0.001). Interpretation: Progressive RNFL thinning occurs as a function of time in some patients with MS, even in the absence of ON, and is associated with clinically significant visual loss. These findings are consistent with subclinical axonal loss in the anterior visual pathway in MS, and support the use of OCT and low-contrast acuity as methods to evaluate the effectiveness of putative neuroprotection protocols.

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