Optical coherence tomography: a window to the optic nerve in clinically isolated syndrome

London, Frédéric; Zephir, Hélène; Drumez, Élodie; Labreuche, Julien; Hadhoum, Nawal; Lannoy, Julien; Hodel, Jérôme; Vermersch, Patrick; Pruvo, Jean‐Pierre; Leclerc, Xavier; Outteryck, Olivier

doi:10.1093/brain/awz038

Cited by 37 publications

(36 citation statements)

References 42 publications

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“…22,23 Second, optic nerve involvement on MRI may have different implications, compared with clinically manifest optic neuritis. 24,25 Importantly, these results do not seem to be affected by selection bias, given that only one patient (out of 10) with MRI optic nerve involvement but asymptomatic for optic neuritis experienced clinically manifest optic neuritis as the first relapse. 26 Finally, optic nerve involvement on MRI at the time of diagnosis may be associated with a shorter asymptomatic period, because the lesion is usually clinically manifest, and earliest phases of disease have been associated with a higher clinical activity in pediatric patients with MS. 6 The exposure to high-efficacy DMT was the only independent predictor of longer time to first relapse.…”

Section: Discussionmentioning

confidence: 88%

Early Predictors of 9‐Year Disability in Pediatric Multiple Sclerosis

Meo

Bonacchi

Moiola

et al. 2021

Annals of Neurology

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The purpose of this study was to assess early predictors of 9-year disability in pediatric patients with multiple sclerosis. Methods: Clinical and magnetic resonance imaging (MRI) assessments of 123 pediatric patients with multiple sclerosis were obtained at disease onset and after 1 and 2 years. A 9-year clinical follow-up was also performed. Cox proportional hazard and multivariable regression models were used to assess independent predictors of time to first relapse and 9-year outcomes. Results: Time to first relapse was predicted by optic nerve lesions (hazard ratio [HR] = 2.10, p = 0.02) and high-efficacy treatment exposure (HR = 0.31, p = 0.005). Predictors of annualized relapse rate were: at baseline, presence of cerebellar (β = −0.15, p < 0.001), cervical cord lesions (β = 0.16, p = 0.003), and high-efficacy treatment exposure (β = −0.14, p = 0.01); considering also 1-year variables, number of relapses (β = 0.14, p = 0.002), and the previous baseline predictors; considering 2-year variables, time to first relapse (2-year: β = −0.12, p = 0.01) entered, whereas high-efficacy treatment exposure exited the model. Predictors of 9-year disability worsening were: at baseline, presence of optic nerve lesions (odds ratio [OR] = 6.45, p = 0.01); considering 1-year and 2-year variables, Expanded Disability Status Scale (EDSS) changes (1-year: OR = 26.05, p < 0.001; 2-year: OR = 16.38, p = 0.02), and ≥ 2 new T2-lesions in 2 years (2-year: OR = 4.91, p = 0.02). Predictors of higher 9-year EDSS score were: at baseline, EDSS score (β = 0.58, p < 0.001), presence of brainstem lesions (β = 0.31, p = 0.04), and number of cervical cord lesions (β = 0.22, p = 0.05); considering 1-year and 2-year variables, EDSS changes (1-year: β = 0.79, p < 0.001; 2-year: β = 0.55, p < 0.001), and ≥ 2 new T2-lesions (1-year: β = 0.28, p = 0.03; 2-year: β = 0.35, p = 0.01). Interpretation: A complete baseline MRI assessment and an accurate clinical and MRI monitoring during the first 2 years of disease contribute to predict 9-year prognosis in pediatric patients with multiple sclerosis.

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Section: Discussionmentioning

confidence: 88%

Early Predictors of 9‐Year Disability in Pediatric Multiple Sclerosis

Meo

Bonacchi

Moiola

et al. 2021

Annals of Neurology

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“…Although SCA was obtained from three-dimensional brain MRI instead of dedicated SC acquisitions, previous work has shown that this is a valid alternative [28]. Although previous ON history was carefully taken into account in the statistical approach, asymptomatic optic nerve lesions frequently occur in patients with MS that could potentially modulate any of the associations with OCT-derived measures and could therefore be considered as a limitation of our study (as well as other previous OCT/MRI studies) [29,30]. Also, as visual function is included in the EDSS score we cannot exclude that the associations observed between pRNFL thickness and EDSS score may be partly explained by OCT measures pRNFL r p = À0.289; P = 0.007 r p = À0.375; P < 0.001 r p = À0.384; P < 0.001 r p = 0.014; P = 0.896 r p = À0.025; P = 0.822 GCIPL r p = À0.279; P = 0.023 r p = À0.304; P = 0.013 r p = À0.352; P = 0.004 r p = 0.084; P = 0.505 r p = À0.159; P = 0.201 INL r p = À0.028; P = 0.825 r p = 0.082; P = 0.513 r p = 0.085; P = 0.499 r p = 0.022; P = 0.862 r p = 0.109; P = 0.382 MRI measures BPF r p = À0.480; P < 0.001 r p = À0.571; P < 0.001 r p = À0.467; P < 0.001 r p = 0.190; P = 0.118 r p = À0.152; P = 0.188 GMF r p = À0.560; P < 0.001 r p = À0.406; P < 0.001 r p = À0.369; P = 0.001 r p = 0.217; P = 0.058 r p = À0.359; P = 0.001 WMF r p = 0.262; P = 0.022 r p = À0.015; P = 0.899 r p = 0.034; P = 0.772 r p = À0.107; P = 0.356 r p = 0.311; P = 0.006 SCA r p = À0.072; P = 0.535 r p = À0.354; P = 0.002 r p = À0.323; P = 0.004 r p = 0.064; P = 0.581 r p = 0.391; P < 0.001 Lesion volume r p = 0.386; P = 0.001 r p = 0.514; P < 0.001 r p = 0.385; P = 0.001 r p = À0.107; P = 0.353 r p = 0.270; P = 0.018…”

Section: Discussionmentioning

confidence: 99%

“…Although SCA was obtained from three‐dimensional brain MRI instead of dedicated SC acquisitions, previous work has shown that this is a valid alternative [28]. Although previous ON history was carefully taken into account in the statistical approach, asymptomatic optic nerve lesions frequently occur in patients with MS that could potentially modulate any of the associations with OCT‐derived measures and could therefore be considered as a limitation of our study (as well as other previous OCT/MRI studies) [29,30]. Also, as visual function is included in the EDSS score we cannot exclude that the associations observed between pRNFL thickness and EDSS score may be partly explained by asymptomatic optic nerve lesions and/or lesion within the optic radiations.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography measures correlate with brain and spinal cord atrophy and multiple sclerosis disease‐related disability

Vidal-Jordana¹,

Pareto

Cabello³

et al. 2020

Euro J of Neurology

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Background and purpose: Both optical coherence tomography (OCT) and magnetic resonance imaging (MRI) volumetric measures have been postulated as potential biomarkers of multiple sclerosis (MS)-related disability. The aim of the study was to investigate the association between OCT and brain volume and spinal cord area (SCA) parameters in patients with relapsing MS and to assess their independent associations with disability. Methods: This was a cross-sectional analysis of 90 patients with MS who underwent OCT and MRI examination. Values of peripapillary retinal nerve fibre layer (pRNFL), ganglion cell/inner plexiform layer (GCIPL) and inner nuclear layer of eyes without previous optic neuritis were obtained. SCA and brain parenchymal fraction (BPF), grey and white matter fractions were obtained. Multivariable regression analyses were conducted with disability as dependent variable. Results: Lower pRNFL thickness and lower GCIPL volume as well as lower BPF, grey matter fraction and SCA were associated with a longer disease duration and a higher Expanded Disability Status Scale score. Lower pRNFL thickness and GCIPL volumes were associated with lower BPF and SCA. In the multivariable logistic regression analyses, pRNFL thickness and GCIPL volume outperformed MRI in predicting disability. Conclusions: The OCT measures correlate with brain and spinal cord atrophy and appear more closely associated with disability than MRI volumetric measures.

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“…In this study, we examined NPC1-P, clinically asymptomatic NPC1-MC, and HC using OCT to identify retinal degeneration and to evaluate the potential eligibility of OCT measures as biomarkers of neurodegeneration and disease progress. OCT proved to be a precise and reproducible method [27] for non-invasive visualization and quantification of retinal layers, and plays a crucial role in analyzing retinal changes in various neurodegenerative [15] and neuroinflammatory diseases [28][29][30]. Due to its anatomical, embryological, and physiological similarities with the brain, the retina offers a unique and easily accessible "window" to study correlates and consequences of subclinical pathology in the brain [31].…”

Section: Discussionmentioning

confidence: 99%

Retinal axonal degeneration in Niemann–Pick type C disease

et al. 2020

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Objective Niemann-Pick disease type C1 (NPC1) is a rare autosomal-recessive lysosomal storage disorder presenting with a broad clinical spectrum ranging from a severe infantile-onset neurovisceral disorder to late-onset neurodegenerative disease. Optical coherence tomography (OCT) is established to detect retinal degeneration in vivo. We examined NPC1-patients (NPC1-P), clinically asymptomatic NPC1-mutation carriers (NPC1-MC), and healthy controls (HC) to (1) identify retinal degeneration in NPC1-disease and (2) to investigate possible subclinical retinal degeneration in NPC1-MC. Methods Fourteen NPC1-P, 17 NPC1-MC, and 31 age-matched HC were examined using spectral-domain OCT. Neurological examinations, clinical scales [modified Disability Rating Scale (mDRS); Scale for the Rating and Assessment of Ataxia (SARA); Spinocerebellar Ataxia Functional Index (SCAFI)], and video-oculography (VOG) were correlated with OCT data. Results Macular retinal nerve fiber layer and volumes of combined ganglion cell and inner plexiform layer were significantly lower in NPC1-P compared to HC [mRNFL (µm):0.13 ± 0.01 vs. 0.14 ± 0.02; p = 0.01; GCIPL (mm 3):0.60 ± 0.05 vs. 0.62 ± 0.04; p = 0.04]. No significant differences were found in NPC1-MC in comparison to HC. In NPC1-P, the amplitude of upward vertical saccades showed positive associations with peripapillary RNFL (ρ = 0.645; p < 0.05), and thinned GCIP (ρ = 0.609; p < 0.05), but not in NPC1-MC. In NPC1-P correlations between combined outer plexiform layer and outer nuclear layer (OPONL) with mDRS (r = − 0.617; p < 0.05) and GCIP with SARA (r = − 0.622; p < 0.05) were observed. Furthermore, in NPC1-MC, motor scores were negatively associated with pRNFL (ρ = − 0.677; p < 0.01). Conclusions Using OCT, we showed retinal degeneration in NPC1-P and significant correlation between retinal neuroaxonal degeneration with clinical measurements. We observed a non-significant trend of retinal degeneration in NPC1-MC correlating with subclinical motor abnormalities. Based on these preliminary data, OCT may be an important marker of neurodegeneration in NPC1-disease after onset of clinical symptoms.

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Optical coherence tomography: a window to the optic nerve in clinically isolated syndrome

Cited by 37 publications

References 42 publications

Early Predictors of 9‐Year Disability in Pediatric Multiple Sclerosis

Early Predictors of 9‐Year Disability in Pediatric Multiple Sclerosis

Optical coherence tomography measures correlate with brain and spinal cord atrophy and multiple sclerosis disease‐related disability

Retinal axonal degeneration in Niemann–Pick type C disease

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