Early factors associated with axonal loss after optic neuritis

Henderson, Andrew; Altmann, Daniel R.; Trip, S Anand; Miszkiel, Katherine; Schlottmann, Patricio G.; Jones, S. J.; Garway-Heath, David; Plant, Gordon T.; Miller, David H.

doi:10.1002/ana.22554

Cited by 43 publications

(43 citation statements)

References 39 publications

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“…Our findings were consistent with previous studies that reported significant RNFL thinning within the first 6 months after the acute optic neuritis and that no further significant interval changes were detected from 6 to 24 months. 7,13 As all of our subjects did not present with papillitis, the amount of longitudinal RNFL thinning may not be as dramatic as other study populations 14,15 that included subjects with initial papillitis, since papillitis would give rise to an initial paradoxical increase in RNFL thickness.…”

Section: Discussionmentioning

confidence: 96%

“…First, this allows for the concomitant use of potential neuroprotective drugs in future clinical trials without fear that the effects of systemic steroid use would confound the degree of RNFL thinning. Secondly, the treatment effects of neuroprotective medication can be monitored with OCT, as previously proposed by Henderson et al 7,17 This study had its limitations. Firstly, the assignment of treatment and non-treatment groups was not randomised, but the authors felt that it would be unethical to withhold treatment in those with a high visual demand when systemic steroids can hasten the visual recovery process.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal Changes in Retinal Nerve Fibre Layer Thickness after an Isolated Unilateral Retrobulbar Optic Neuritis: 1-Year Results

Yau

Lee

Lau

et al. 2015

Neuro-Ophthalmology

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The objective of this study was to investigate the longitudinal changes in retinal nerve fibre layer (RNFL) thickness 1 year after an episode of unilateral acute optic neuritis. This prospective cohort study recruited consecutive patients with a first episode of isolated, unilateral acute optic neuritis from October 2010 to June 2013. RNFL thickness of the attack and normal fellow eyes was measured by optical coherence tomography on presentation and 3, 6, and 12 months post attack in both the treatment and non-treatment groups. The treatment group consisted of subjects that opted for systemic steroids to hasten recovery time. In 20 subjects, 11 received systemic steroids and 9 were treated conservatively. The baseline RNFL thickness was similar in the attack and fellow eyes (p ! 0.4). Progressive RNFL thinning was seen in the attack eye over the 12-month period, with significant differences for baseline versus 3 months; baseline versus 12 months; and 3 versus 12 months (all p50.0001). At 12 months, the attack eye had a thinner average RNFL than the fellow eye (100.9 ± 6.1 versus 107.3 ± 5.5 mm; p = 0.002). The 12-month RNFL was similar between the treatment and non-treatment groups (p ! 0.6). A single episode of optic neuritis triggered an accelerated, progressive RNFL thinning up to 6 months post attack. Initial treatment with systemic steroids did not seem to alter the degree of RNFL loss at 12 months.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Longitudinal Changes in Retinal Nerve Fibre Layer Thickness after an Isolated Unilateral Retrobulbar Optic Neuritis: 1-Year Results

Yau

Lee

Lau

et al. 2015

Neuro-Ophthalmology

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“…The fact that the measures did not correlate in this cohort emphasizes that each test addresses distinct components of vision. P100 prolongation early after ON predicts later retinal axonal loss (27), thus VEPs may have utility as a prognostic biomarker. However, an isolated change in VEP latency among stable MS patients may be dissociated from other aspects of visual function and the patient's ability to function.…”

Section: Discussionmentioning

confidence: 99%

Quantitative visual tests after poorly recovered optic neuritis due to multiple sclerosis

Longbrake

Lancia

Tutlam

et al. 2016

Multiple Sclerosis and Related Disorders

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Background Visual dysfunction in MS can be quantified using a variety of tests. Many vision tests have not been formally evaluated among MS patients with existing visual dysfunction. Objective Evaluate several versions of visual acuity and contrast sensitivity tests, measures of central and peripheral vision, retina structure, electrophysiologic function, and quality of life among MS patients with moderate/severe visual dysfunction. Methods Cross-sectional study of 46 patients with stable, incompletely recovered optic neuritis. Testing included Snellen eye charts, several Sloan low contrast charts, Pelli Robson (PR) contrast sensitivity charts, optical coherence tomography, visual fields, Farnsworth Munsell 100-hue test, visual evoked potentials (VEP), and visual function quality of life (VFQ-25) testing. Results 98% of eyes could read two lines of the PR chart, while only 43% read the 2.5% contrast chart. Low contrast tests correlated strongly with each other and with retinal nerve fiber layer (RNFL) thickness, visual fields, and color vision but not with VEPs. For patients with RNFL <75μm, VFQ-25 scores dropped by approximately 2 points for every 1 μm decrease in RNFL. Conclusion Among MS patients with visual impairment due to optic neuritis, PR contrast sensitivity could be utilized as a single chart. Visual quality of life was associated with RNFL thinning below 75μm.

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“…Several mechanisms have been proposed by which axonal loss caused by MS disease could lead to tissue degeneration and ultrastructural changes of the retinal ganglionar cells, astrocytes, and endothelial cells [19,20], and are supported by evidence based on the effects of ON on the RNFL [4,21,22,23]. …”

Section: Introductionmentioning

confidence: 94%

Three-Dimensional Geometries Representing the Retinal Nerve Fiber Layer in Multiple Sclerosis, Optic Neuritis, and Healthy Eyes

García‐Martín

Calvo²,

Malvè³

et al. 2013

Ophthalmic Res

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Background: To represent and interpret the three-dimensional (3D) geometry and the distribution of the axonal damage to the retinal nerve fiber layer (RNFL) in patients with multiple sclerosis (MS) compared with healthy subjects. To analyze alterations in RNFL morphology in eyes of MS patients with or without previous episodes of optic neuritis (ON). Methods: MS patients (n = 122) and age-matched healthy subjects (n = 108) were enrolled. The Spectralis optical coherence tomography system was used to determine the circumpapillary RNFL thickness. The 768 RNFL thickness measurements were used to evaluate thickness measurements in patients with or without antecedent ON and to design a 3D reconstruction of the RNFL thickness representing the mechanobiologic tissue response to neurodegeneration caused by MS and ON episodes. Results: RNFL thickness was decreased in MS patients, and was higher in the MS group with previous ON. Statistical analysis and 3D RNFL reconstruction revealed greater damage to the ganglionar cells in the superonasal RNFL area (101.77 µm in MS vs. 125.47 µm in healthy subjects) and in the inferotemporal RNFL (119.05 µm in MS eyes and 149.26 µm in healthy eyes). Conclusions: The 3D representation of RNFL thickness based on measurements allows physicians to better observe damage in the temporal areas, especially in patients with previous ON.

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Early factors associated with axonal loss after optic neuritis

Cited by 43 publications

References 39 publications

Longitudinal Changes in Retinal Nerve Fibre Layer Thickness after an Isolated Unilateral Retrobulbar Optic Neuritis: 1-Year Results

Longitudinal Changes in Retinal Nerve Fibre Layer Thickness after an Isolated Unilateral Retrobulbar Optic Neuritis: 1-Year Results

Quantitative visual tests after poorly recovered optic neuritis due to multiple sclerosis

Three-Dimensional Geometries Representing the Retinal Nerve Fiber Layer in Multiple Sclerosis, Optic Neuritis, and Healthy Eyes

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