Retinal and Optic Nerve Degeneration in Patients with Multiple Sclerosis Followed up for 5 Years

García‐Martín, Elena; Ara, J.R.; Martín, Javier Montero; Almárcegui, Carmen; Dolz, Isabel; Viladés, Elisa; Gil-Arribas, L.; Fernández, Francisco Javier Fernández; Polo, Vicente; Larrosa, José M.; Júlvez, Luis Pablo; Satué, María

doi:10.1016/j.ophtha.2017.01.005

Cited by 80 publications

(50 citation statements)

References 32 publications

(26 reference statements)

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“…Also, after 3 years, thinning of the optic nerve could be detected by OCT and TOS in eyes despite no acute episodes having occurred during this interval. This is in line with previous prospective studies that confirm that MS patients experience loss of retinal ganglion cells and therefore thinning of the RNFL due to axonal loss in the optic nerve, even in the absence of ON(Garcia-Martin et al, 2017, 2011Petzold et al, 2010). Severalhypotheses have been proposed to explain this phenomenon, including trans-synaptic retrograde degeneration caused by lesions affecting the posterior visual pathways, primary damage to the retina, and subclinical demyelination in the optic nerve (Vidal-Jordana, Sastre-Garriga, & Montalban, 2012).…”

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confidence: 93%

Functional and structural changes in the visual pathway in multiple sclerosis

et al. 2019

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IntroductionMultiple sclerosis (MS) is a heterogeneous disease with an unpredictable course. Visual pathway is a target of the disease and may reflect mechanisms that lead to disability. Structural and functional changes in the visual pathway may be studied by noninvasive techniques such as optical coherence tomography (OCT), visual evoked potentials (VEP), or B‐mode transorbital sonography (TOS).ObjectivesThe aim is to assess changes in the visual pathway in eyes of MS patients with and without a history of optic neuritis over a 3‐year period and to explore their relationship with disability.Materials and MethodsIn total, 112 eyes from 56 patients with relapsing MS were recruited: 29 with, and 83 without a history of ON (hON and nhON, respectively). Several parameters were measured by OCT, VEP, and TOS. Baseline measurements were also compared to 29 healthy controls. At 36 months, measurements were repeated in all eyes.ResultsAt baseline, all tests showed significant differences in optic nerve structure and function in both patient cohorts in all the parameters studied, suggestive of more impairment of the visual pathway among the hON cohort. OCT showed significant differences between healthy controls and the nhON cohort. At 36 months, the nhON cohort showed significant changes by OCT, VEP, and TOS suggestive of further visual pathway impairment. OCT measurements also correlated with baseline EDSS among the nhON cohort.ConclusionsOCT is the most suitable technique and outperforms VEP and TOS to detect subclinical damage in the visual pathway. It discriminated MS patients from healthy controls and showed a progressive decline in optic nerve thickness over time among these patients.

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confidence: 93%

Functional and structural changes in the visual pathway in multiple sclerosis

et al. 2019

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“…It has been effectively used to assess disease progression in patients with neurodegenerative conditions such as multiple sclerosis. 12,13 OCT has been suggested as a surrogate measure for brain damage in some systemic diseases, such as migraine.…”

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confidence: 99%

Retinal Microvascular Impairment in the Early Stages of Parkinson's Disease

Kwapong

Peng

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To detect the retinal microvascular impairment using optical coherence tomography angiography (OCT-A) in patients with Parkinson's disease (PD) and find a correlation between the microvascular impairment and the neuronal damage.METHODS. This is a prospective, observational study including 49 eyes from 38 PD patients in their early stages and 34 eyes from 28 healthy controls with comparable age range. Macula microvasculature was evaluated with the spectral-domain optical coherence tomography (SD-OCT) angiography and intraretinal layer thickness evaluated with the SD-OCT. A custom algorithm was used for custom segmentation of retinal thickness and quantification of the superficial and deep microvascular density of the macula, respectively.RESULTS. PD patients showed reduced microvascular density in most of the areas of the whole retina. In the superficial retinal capillary plexus, statistical difference (P < 0.01) was seen in the total annular zone (TAZ), superior, temporal, inferior, and nasal zones. In PD patients, there was a strong correlation between the average ganglion cell layer and inner plexiform (GCIP) thickness and the TAZ of the superficial microvascular density (r ¼ 0.062, P ¼ 0.032).CONCLUSION. We demonstrated that retinal microvascular density decreased in PD patients. The correlation between microvascular impairment in the superficial retinal capillary layer and GCIP thinning also revealed that the retinal microvascular abnormality may contribute to the neurodegeneration in PD patients. OCT-A with quantitative analysis offers a new path of study and will likely be useful in the future as an objective biomarker for detecting vessel impairment in early stages of PD.

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“…This last finding is an important one if we plan on using OCT as a surrogate marker for neurodegeneration in individual patients. The expected rate of pRNFL atrophy in MS patients is about 1-2 µm/year (5,14,15) and is even lower in patients with a longer disease duration. (16) A large part of our scans showed a degree of difference in pRNFL thickness measurement between the two versions that could mask or overestimate the true pRNFL atrophy, which is presumed to be caused by retrograde trans-synaptic degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…A limitation of this study is the fact that we did not investigate whether this problem also occurs with OCT machines and segmentation software by other manufacturers. For example, a number of studies in MS have been performed with the Cirrus OCT by Carl Zeiss Meditec (16,(21)(22)(23)(24)(25) and five with the Cirrus OCT (15,(26)(27)(28)(29). It is plausible that this problem might occur with these OCT devices as well, but this still remains to be investigated and these groups are well placed to investigate this point.…”

Section: Discussionmentioning

confidence: 99%