TY - JOUR
T1 - Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness
AU - Saidha, Shiv
AU - Syc, Stephanie B.
AU - Durbin, Mary K.
AU - Eckstein, Christopher
AU - Oakley, Jonathan D.
AU - Meyer, Scott A.
AU - Conger, Amy
AU - Frohman, Teresa C.
AU - Newsome, Scott
AU - Ratchford, John N.
AU - Frohman, Elliot
AU - Calabresi, Peter A.
N1 - Funding Information:
Dr Shiv Saidha has received consulting fees from MedicalLogix for the development of continuing medical education programs in neurology. Dr Christopher Eckstein receives funding through a Sylvia Lawry Physician Fellowship from the National Multiple Sclerosis Society. Jonathan Oakley, Mary Durbin and Scott Meyer are employed by Carl Zeiss Meditec Inc. Dr Elliot Frohman has received speaker honoraria and consulting fees from Biogen Idec, TEVA, and Athena. He has also received consulting fees from Abbott Laboratories. Dr Scott Newsome has received speaker honoraria and consulting fees from Biogen Idec. Dr John Ratchford has consulted for Sun Pharmaceuticals. Dr Peter Calabresi has provided consultation services to Novartis, EMD-Serono, Teva, Biogen-IDEC, Vertex, Vaccinex, Genzyme, Genentech; and has received grant support from EMD-Serono, Teva, Biogen-IDEC, Genentech, Bayer, Abbott, and Vertex. Stephanie Syc and Teresa Frohman have no disclosures.
PY - 2011/12
Y1 - 2011/12
N2 - Background: Post-mortem analyses of multiple sclerosis (MS) eyes demonstrate prominent retinal neuronal ganglion cell layer (GCL) loss, in addition to related axonal retinal nerve fiber layer (RNFL) loss. Despite this, clinical correlations of retinal neuronal layers remain largely unexplored in MS.Objectives: To determine if MS patients exhibit in vivo retinal neuronal GCL loss, deeper retinal neuronal loss, and investigate correlations between retinal layer thicknesses, MS clinical subtype and validated clinical measures.Methods: Cirrus HD-optical coherence tomography (OCT), utilizing automated intra-retinal layer segmentation, was performed in 132 MS patients and 78 healthy controls. MS classification, Expanded Disability Status Scale (EDSS) and visual function were recorded in study subjects.Results: GCL+inner plexiform layer (GCIP) was thinner in relapsing-remitting MS (RRMS; n = 96, 71.6 μm), secondary progressive MS (SPMS; n = 20, 66.4 μm) and primary progressive MS (PPMS; n = 16, 74.1 μm) than in healthy controls (81.8 μm; p < 0.001 for all). GCIP thickness was most decreased in SPMS, and although GCIP thickness correlated significantly with disease duration, after adjusting for this, GCIP thickness remained significantly lower in SPMS than RRMS. GCIP thickness correlated significantly, and better than RNFL thickness, with EDSS, high-contrast, 2.5% low-contrast and 1.25% low-contrast letter acuity in MS. 13.6% of patients also demonstrated inner or outer nuclear layer thinning.Conclusions: OCT segmentation demonstrates in vivo GCIP thinning in all MS subtypes. GCIP thickness demonstrates better structure-function correlations (with vision and disability) in MS than RNFL thickness. In addition to commonly observed RNFL/GCIP thinning, retinal inner and outer nuclear layer thinning occur in MS.
AB - Background: Post-mortem analyses of multiple sclerosis (MS) eyes demonstrate prominent retinal neuronal ganglion cell layer (GCL) loss, in addition to related axonal retinal nerve fiber layer (RNFL) loss. Despite this, clinical correlations of retinal neuronal layers remain largely unexplored in MS.Objectives: To determine if MS patients exhibit in vivo retinal neuronal GCL loss, deeper retinal neuronal loss, and investigate correlations between retinal layer thicknesses, MS clinical subtype and validated clinical measures.Methods: Cirrus HD-optical coherence tomography (OCT), utilizing automated intra-retinal layer segmentation, was performed in 132 MS patients and 78 healthy controls. MS classification, Expanded Disability Status Scale (EDSS) and visual function were recorded in study subjects.Results: GCL+inner plexiform layer (GCIP) was thinner in relapsing-remitting MS (RRMS; n = 96, 71.6 μm), secondary progressive MS (SPMS; n = 20, 66.4 μm) and primary progressive MS (PPMS; n = 16, 74.1 μm) than in healthy controls (81.8 μm; p < 0.001 for all). GCIP thickness was most decreased in SPMS, and although GCIP thickness correlated significantly with disease duration, after adjusting for this, GCIP thickness remained significantly lower in SPMS than RRMS. GCIP thickness correlated significantly, and better than RNFL thickness, with EDSS, high-contrast, 2.5% low-contrast and 1.25% low-contrast letter acuity in MS. 13.6% of patients also demonstrated inner or outer nuclear layer thinning.Conclusions: OCT segmentation demonstrates in vivo GCIP thinning in all MS subtypes. GCIP thickness demonstrates better structure-function correlations (with vision and disability) in MS than RNFL thickness. In addition to commonly observed RNFL/GCIP thinning, retinal inner and outer nuclear layer thinning occur in MS.
KW - EDSS
KW - ganglion cell layer
KW - multiple sclerosis
KW - optical coherence tomography
KW - retinal pathology
KW - retinal segmentation
KW - visual function
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U2 - 10.1177/1352458511418630
DO - 10.1177/1352458511418630
M3 - Article
C2 - 21865411
AN - SCOPUS:82555199779
SN - 1352-4585
VL - 17
SP - 1449
EP - 1463
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 12
ER -