Bruch’s membrane opening-minimum rim width: An alternative OCT biomarker study for multiple sclerosis

Abstract

Purpose: Bruch’s membrane opening-minimum rim width (BMO-MRW) and RNFL measured using anatomic positioning system (APS-RNFL) are novel OCT methods and remained unexplored in MS patients. To investigate the novel parameters of spectral-domain OCT as an alternative biomarker in patients with multiple sclerosis (MS). Methods: Retrospective cohort study; participants consisted of relapsing-remitting MS (RRMS) patients and healthy controls (HC). Eyes were classified according to the presence of MS and previous optic neuritis (ON). Measurements of standard peripapillary RNFL (S-RNFL), BMO-MRW, and APS-RNFL were performed. Result: A total of 244 eyes of 122 participants (MS-patients: 63, HC: 59) were included in the study. Fifty-one eyes had a history of previous ON. In almost all measured parameters, neuroretinal rim thicknesses were observed the thinnest in eyes with ON history between all subgroups. S-RNFL and APS-RNFL techniques showed the difference in neuroretinal rim thickness in all three subjects (ON+, ON−, and HC). However, BMO-MRW, on the other hand, could not distinguish between ON(−) patients and HC. The relationship between OCT parameters and EDSS were observed only in eyes with an ON history in all three techniques. A meaningful model with 78% accuracy was obtained by using only the OCT parameters as risk factors. In the ROC analysis, no parameters were found to have acceptable high sensitivity and specificity. BMO-MRW was statistically weaker in every aspect than other RNFL techniques. Conclusion: The novel APS-RNFL technique appears to be a bit more reliable alternative to S-RNFL technique to support therapeutic decision-making in MS. BMO-MRW has not been found as a successful alternative to S-RNFL.

Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects

“…Other, more unusual parameters, such as the thickness of lamina cribrosa and the Bruch’s membrane opening-minimum rim width, are of no utility for discriminating between patients with and without a history of ON [ 23 , 24 ].…”

Gibt es statisch-strukturelle Biomarker bei den Glaukomen mit der OCT?

“…Die einfache Optikusatrophie anderer Genese zeigt die Verdünnung der BMO-MRW in viel geringerem Maße als bei den Glaukomen. Bei MS fanden Nguyen et al [5] mit BMO-MRW nur eine grenzwertige Korrelation mit der Kontrastempfindlichkeit und Özbilen et al [6] befanden BMO-MRW als für MS unspezifischen Biomarker. Jonas et al [7] beschrieben bei der einfachen Optikusatrophie nur eine geringgradig vergrößerte Exkavation, ophthalmoskopisch zeigt sich die Papille blass und im Niveau flacher als vitale Papillen.…”

“…Simple optical nerve atrophy from other causes is characterized by a much lower level of BMO-MRW thinning than is the case in glaucomas. In MS cases, Nguyen et al [5] determined only a marginal correlation between BMO-MRW and contrast sensitivity and Özbilen et al [6] found BMO-MRW to be a non-specific biomarker for MS. In cases of simple optic nerve atrophy, Jonas [7] described only slightly enlarged excavation and ophthalmoscopy shows pallid papillae with a flatter level than vital papillae.…”

“…6 A-Scans pro Sekunde. Damit sind empfindliche Strukturen wie die Ganglienzellschicht der Makula (GCL), die RNFL und der Sehnervenkopf bis zur Lamina cribrosa mit einer axialen Auflösung von bis zu 3,9 µm ähnlich einem histologischen In-vivo-Schnitt darstellbar[1].…”

Analysis of risk and protective factors associated with retinal nerve fiber layer defect in a Chinese adult population

“…Many diseases can damage this neural pathway, leading to retinal nerve fiber layer defect (RNFLD). RNFLD can be found in eyes with ischemic optic neuropathy, glaucomatous optic neuropathy, optic disc drusen, retinitis pigmentosa, retinal artery occlusion, contusion of the optic nerve, compression of pituitary tumor, visual pathway impairment, toxic optic neuropathy, and as a sequela of long-standing papilledema, optic neuritis, etc [1][2][3][4][5][6][7][8] . In addition, many risk factors, such as age, race, gender, blood pressure, blood glucose, smoke, etc., are known to increase an individual's chance of developing RNFLD [9][10][11] .…”