Dynamics of retinal injury after acute optic neuritis

Gabilondo, Iñigo; Martínez-Lapiscina, Elena H.; Fraga-Pumar, Elena; Ortiz-Pérez, Santiago; Torres-Torres, Rubén; Andorrà, Magí; Llufriú, Sara; Zubizarreta, Irati; Sáiz, Albert; Sánchez-Dalmau, Bernardo; Villoslada, Pablo

doi:10.1002/ana.24351

Cited by 155 publications

(157 citation statements)

References 29 publications

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“…Another study reported that the pRNFL and GCIPL thicknesses were reduced by 45.3% and 11.3%, respectively, in ON patients after 6 months of follow-up. 23 In our study, however, the average pRNFL and GCIPL thickness reduced by 48.0% and 12.26%, respectively, after 6 months. We think that the discrepancy in the degree of RNFL reduction that is reported in various studies may be a result of the patient selection criteria, including ethnic differences and different rates of retrobulbar ON.…”

Section: Discussioncontrasting

confidence: 70%

Retinal ganglion cell and axonal loss in optic neuritis: risk factors and visual functions

Lee

Park

et al. 2016

Eye

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Purpose The peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cellinner plexiform layer (GCIPL) are important predictive factors for the prognosis of optic neuritis (ON). We investigated the risk factors for pRNFL and GCIPL thinning in ON and its relationship with visual function. Patients and methods We analyzed 33 eyes of 33 patients with a first attack of unilateral ON. Patients were divided into two groups according to pRNFL and GCIPL thinning, using spectral-domain optical coherence tomography. We evaluated patients' age, sex, color vision, visual acuity (VA), optic nerve findings on MRI, elapsed period from onset of visual symptoms to steroid treatment, visual field (VF) mean deviation (MD), average pRNFL thickness, and GCIPL thickness. Results There was no patient with residual VF defect in the groups without pRNFL or GCIPL thinning. Significant correlations were found between pRNFL (some sectors) and GCIPL (all sectors) thickness and BCVA and VF MD (Po0.03 for all). Multivariate logistic regression analysis revealed that only worse initial VF MD was a significant risk factor of pRFNL and GCIPL thinning after ON (OR, 0.841; 95% CI, P = 0.017 and OR, 0.871; 95% CI, P = 0.046, respectively). Conclusion Retinal ganglion cell and axonal losses occurred in ON cases showing severe initial VF loss. Therefore, it is necessary to pay more attention to the degree of initial VF loss in ON while considering the possibility of residual VF loss accompanying pRNFL and GCIPL thinning.

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Section: Discussioncontrasting

confidence: 70%

Retinal ganglion cell and axonal loss in optic neuritis: risk factors and visual functions

Lee

Park

et al. 2016

Eye

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“…Importantly, retrograde transsynaptic atrophy in the retina stops at the level of the INL 8, 9, 10, 11. The preservation of the INL following MSON is understood to be due to multiple afferent inputs through a network of horizontal and amacrine cells 8, 12, 13.…”

Section: Introductionmentioning

confidence: 99%

Structure‐function relationships in the visual system in multiple sclerosis: an MEG and OCT study

Tewarie

Balk

Hillebrand

et al. 2017

Ann Clin Transl Neurol

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BackgroundWe conducted a multi‐modal optical coherence tomography (OCT) and magnetoencephalography (MEG) study to test whether there is a relationship between retinal layer integrity and electrophysiological activity and connectivity (FC) in the visual network influenced by optic neuritis (ON) in patients with multiple sclerosis (MS).MethodsOne hundred and two MS patients were included in this MEG/OCT study. Retinal OCT data were collected from the optic discs, macular region, and segmented. Neuronal activity and FC in the visual cortex was estimated from source‐reconstructed resting‐state MEG data by computing relative power and the phase lag index (PLI). Generalized estimating equations (GEE) were used to account for intereye within‐patient dependencies.ResultsThere was a significant relationship for both relative power and FC in the visual cortex with retinal layer thicknesses. The findings were influenced by the presence of MSON, particularly for connectivity in the alpha bands and the outer macular layers. In the absence of MSON, this relationship was dominated by the lower frequency bands (theta, delta) and inner and outer retinal layers.ConclusionThese results suggest that visual cortex FC more than activity alters in the presence of MSON, which may guide the understanding of FC plasticity effects following MSON.

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“…The fact that the thickness of the peripapillar and macular retinal nerve fiber layer (pRNFL and mRNFL) and ganglion cell layer combined with the inner plexiform layer (GCIP) were reduced in the affected eye after 6 months, confirms that these cells are the primary cellular site of the disease (Al‐Louzi et al., 2015; Gabilondo et al., 2015; Henderson et al., 2010). The GCIP layer was the preferred outcome measure over the pRNFL and mRFNL, since the GCIP layer is unaffected by optic disc edema and therefore provides more precise information on the structural retinal changes caused by ON (Syc et al., 2012).…”

Section: Discussionmentioning

confidence: 99%

“…The GCIP layer was the preferred outcome measure over the pRNFL and mRFNL, since the GCIP layer is unaffected by optic disc edema and therefore provides more precise information on the structural retinal changes caused by ON (Syc et al., 2012). The increased thickness of outer retinal layers after 6 months, followed by a slight thickness reduction of all retinal layers at 12 months may be due to involvement of the dentritical part of the retinal ganglion cells and a transitory reaction in the outer retina triggered by the inflammatory activity in the inner retina (Al‐Louzi et al., 2015; Gabilondo et al., 2015). Another possibility is that the observed increased thickness was caused by test–retest variability, even though the OSCAR‐IB criteria were rigorously followed (Oberwahrenbrock et al., 2015; Schippling et al., 2014; Tewarie et al., 2012).…”

Section: Discussionmentioning

confidence: 99%

“…This is supported by the current study's observation that nontreated patients experienced an early reduction in the pRNFL thickness and a delayed improvement of visual acuity and color mixing. The increased thickness of the photoreceptor layer in the treated groups after 6 months confirms findings of swelling of the outer retinal layers in eyes treated with steroids (Gabilondo et al., 2015). This seemingly paradoxical reaction could not be related to changes in the inner retinal layers as also observed by others (Al‐Louzi et al., 2015) and requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

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Time to steroid treatment in severe acute optic neuritis

et al. 2018

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ObjectivesSteroid treatment can accelerate visual recovery in patients with optic neuritis (ON), but it is unknown whether the timing of the start of treatment influences the outcome. The main purpose of this observational study was to assess the effect of early onset steroid treatment of ON on visual prognosis and retinal morphology.MethodsForty‐nine patients with acute mild/moderate (n = 21) or severe (n = 28) ON, and an equal number of healthy controls were enrolled. Patients with severe ON either received early onset steroid treatment (initiated within 1 week of presentation with visual loss) (n = 9), late‐onset treatment (initiated after 1 week) (n = 13), or no treatment (n = 6). Visual function and retinal morphology was studied after 6 and 12 months.ResultsAll measures of visual function had improved after 6 months (p ≤ 0.03) in the three groups with severe ON. This was not the case for Rayleigh match setting range (SR) in the nontreated group (p = 0.24), or for SR (p = 0.08) and latency to P100 of visual evoked potential (p = 0.08) in the late‐onset treated group. After 12 months, further improvement occurred in the nontreated and late‐treated groups, but not in the early treated group. Macular retinal nerve fiber layer (mRNFL) and ganglion cell plus inner plexiform layer had decreased significantly (p ≤ 0.001) in all three groups with severe ON after 6 months. After 12 months, only mRNFL had further significantly decreased and only in the late‐onset treated group (p = 0.02).ConclusionThe beneficial effects of early onset steroid treatment of ON is limited to a few months whereas the long‐term prognosis is independent of the timing of treatment.

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Dynamics of retinal injury after acute optic neuritis

Abstract: Retinal axonal and neuronal damage develops quickly after ON onset. Assessment of ganglion cell layer thickness by OCT after ON onset can be used as an imaging marker of persistent visual disability.

Cited by 155 publications

References 29 publications

Retinal ganglion cell and axonal loss in optic neuritis: risk factors and visual functions

Retinal ganglion cell and axonal loss in optic neuritis: risk factors and visual functions

Structure‐function relationships in the visual system in multiple sclerosis: an MEG and OCT study

Time to steroid treatment in severe acute optic neuritis

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