Progressive Degeneration of the Retinal Nerve Fiber Layer in Patients with Multiple Sclerosis

Herrero, Raquel; García‐Martín, Elena; Almárcegui, Carmen; Ara, J.R.; Rodríguez-Mena, Diego; Martín, Javier Montero; Otı́n, Santos; Satué, María; Júlvez, Luis Pablo; Fernández, Francisco Javier Fernández

doi:10.1167/iovs.12-10362

Cited by 55 publications

(43 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…50 OCT measurements are starting to be used as part of the data collection in trials of treatments. Patients with MS and healthy controls were followed up for 3 years, measuring multiple ophthalmic items including OCT. 51 About half of the patients with MS were receiving treatment-with b-interferon 1b, b-interferon 1a or glatiramer. Not only did the MS group show RNFL thinning, but untreated patients with MS also showed more degeneration in the mean and superior RNFL thicknesses than those treated.…”

Section: Neurodegenerative Diseasementioning

confidence: 99%

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

MacGillivray¹,

Trucco²,

Cameron³

et al. 2014

BJR

112

View full text Add to dashboard Cite

imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions. Br J Radiol 2014;87:20130832. REVIEW ARTICLERetinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions 1,2 T J MACGILLIVRAY, MSc ABSTRACTThe black void behind the pupil was optically impenetrable before the invention of the ophthalmoscope by von Helmholtz over 150 years ago. Advances in retinal imaging and image processing, especially over the past decade, have opened a route to another unexplored landscape, the retinal neurovascular architecture and the retinal ganglion pathways linking to the central nervous system beyond. Exploiting these research opportunities requires multidisciplinary teams to explore the interface sitting at the border between ophthalmology, neurology and computing science. It is from the detail and depth of retinal phenotyping that novel metrics and candidate biomarkers are likely to emerge. Confirmation that in vivo retinal neurovascular measures are predictive of microvascular change in the brain and other organs is likely to be a major area of research activity over the next decade. Unlocking this hidden potential within the retina requires integration of structural and functional data sets, that is, multimodal mapping and longitudinal studies spanning the natural history of the disease process. And with further advances in imaging, it is likely that this area of retinal research will remain active and clinically relevant for many years to come. Accordingly, this review looks at state-of-the-art retinal imaging and its application to diagnosis, characterization and prognosis of chronic illness or long-term conditions.Currently about 20 million people in the UK suffer from at least 1 long-term condition (a health problem that cannot be cured but can be controlled by medication or other therapies), and this is set to increase 3-fold over the next decade placing an enormous economic and humanresource strain on the National Health Service.1-3 The retina is unique in the body in allowing easy observation of blood vessels with simple, non-invasive instruments. It is also the only accessible site for studying the central nervous system (CNS) in vivo.4 This makes it a ripe environment for the study of systemic and neurological disease, in a patient-acceptable way. Changes to the retina can occur in some chronic diseases years before other signs become apparent. [5][6][7][8][9] Thus, studying the retina may provide an additional means for clinicians to stratify risk and help identify people who would benefit from early lifestyle changes and preventative therapies, as well as assessing the efficacy of new treatments. In addition, there is some early evidence that certain retinal measures may correlate with disease characterization and also prognosis, which not only provides clinicians with a useful assessment tool but also offers research scientists new avenues to explore in the understanding of the p...

show abstract

Section: Neurodegenerative Diseasementioning

confidence: 99%

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

MacGillivray¹,

Trucco²,

Cameron³

et al. 2014

BJR

112

View full text Add to dashboard Cite

show abstract

“…Briefly, the measurement of RNFL appears to be a valuable tool for monitoring the progression of axonal degeneration in MS disease. 1 MS primarily affects young women, which can explain the relative predominance of female patients in our study. 23 This predominance may bring the question of possible effect of gender on our findings.…”

Section: Discussionmentioning

confidence: 70%

“…1 Among various ophthalmic abnormalities, optic neuritis is the most widely described visual disturbance in MS, but less common manifestations such as uveitis and ophthalmoplegia secondary to cranial nerve palsy may also occur. 2,3 Recently, it was reported that retinal nerve fibre layer (RNFL), which comprises non-myelinated axons of retinal ganglion cells, reflects the disease activity in MS. 1,4 The underlying pathophysiology is unknown, but some recent models support the presence of three mechanisms including inflammation, demyelination, and neurodegeneration in MS. 4 A secondary vascular dysfunction has also been proposed, which might cause a reduction in optic disc and choroidal perfusion. 5 Ocular pulse amplitude (OPA) is the difference between the systolic and diastolic intraocular pressure (IOP).…”

Section: Introductionmentioning

confidence: 99%

Decreased Ocular Pulse Amplitude and Retinal Nerve Fibre Layer in Multiple Sclerosis

Çetin¹,

Erdoǧan

Acer³

et al. 2013

Neuro-Ophthalmology

View full text Add to dashboard Cite

This study was conducted to assess ocular pulse amplitude and retinal nerve fibre layer in patients with multiple sclerosis and their correlation with disease duration and with severity. Retinal nerve fibre layer thickness was measured by Heidelberg Retinal Tomography II (HRT-II; Heidelberg Engineering, Dossenheim, Germany) and ocular pulse amplitude was measured by dynamic contour tonometry (Ziemer Ophthalmic Systems, Port, Switzerland) in 37 multiple sclerosis patients and 72 age-and gender-matched controls. Ocular pulse amplitude was significantly reduced and retinal nerve fibre layer was significantly thinner in temporal, superotemporal, and nasal sectors in patients with multiple sclerosis regardless of having an optic neuritis attack. The retinal nerve fibre layer was thinner in eyes with a previous optic neuritis attack compared with the eyes without an attack, but the difference was not significant. Ocular pulse amplitude showed a positive correlation with visual evoked potential amplitude and a negative correlation with visual evoked potential latency. Retinal nerve fibre layer thickness showed a significant negative correlation with the disease duration but not with visually evoked potential, disease severity, nor previous optic neuritis. These findings indicate that the process of degeneration starts in the early period of the disease, as our study group is composed of earlymiddle-stage multiple sclerosis patients, and is independent of relapses.

show abstract

“…11,12 It is known that RNFL thickness of healthy individuals without any history of neurological or ocular disorders decrease over time. 13 In this research, our aim was to study RNFL and optic nerve head parameters in a cohort of relapsing-remitting (RRMS) subtype of MS patients without a history of prior ON and new clinical attack during the follow-up of 20 months in comparison with the healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography in Patients with Relapsing-Remitting Multiple Sclerosis without Optic Neuritis: A 20-Month Longitudinal Study

Huseyinoglu¹,

Özben²,

Ekinci

et al. 2013

Neuro-Ophthalmology

View full text Add to dashboard Cite

Optical coherence tomography is supported and used as a technique for visualisation of neuro-axonal loss in multiple sclerosis, but there are also a few studies expressing the opposite view. The aim of our study was to investigate retinal nerve fibre layer and optic nerve head parameters in patients with multiple sclerosis without a history of prior optic neuritis and symptoms of a new clinical attack during the follow-up for a total of 20-month period. Full ophthalmic evaluation was performed for all of the participants. The baseline retinal nerve fibre layer and macular thicknesses and focal and global loss of macular volume values were significantly lower in the eyes of the patients with multiple sclerosis compared with the healthy controls. No significant change between baseline and follow-up scans were found in all optical coherence tomography parameters in the multiple sclerosis group. Statistical analyses revealed significant retinal nerve fibre layer and macular thickness differences between baseline and second measurements in the controls. No significant difference in percent change between baseline and second measurements was observed between the patient and control groups. We conclude that whereas healthy subjects have an age-related tendency toward a decrease in retinal nerve fibre layer thickness, patients with multiple sclerosis patients are likely to pass through different stages of retinal thinning and thickening due to subclinical optic neuritis and, as a result, we could not detect any statistically significant change between baseline and second measurements in our multiple sclerosis patients.

show abstract

Progressive Degeneration of the Retinal Nerve Fiber Layer in Patients with Multiple Sclerosis

Abstract: Progressive axonal loss can be detected in the optic nerve fiber layer of MS patients. Analysis of the RNFL by OCT can be useful for evaluating MS progression and efficacy of treatment as a neuroprotective factor against axonal degeneration.

Cited by 55 publications

References 41 publications

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

Decreased Ocular Pulse Amplitude and Retinal Nerve Fibre Layer in Multiple Sclerosis

Optical Coherence Tomography in Patients with Relapsing-Remitting Multiple Sclerosis without Optic Neuritis: A 20-Month Longitudinal Study

Contact Info

Product

Resources

About