Retinal ganglion cell analysis in multiple sclerosis and optic neuritis: a systematic review and meta-analysis

Abstract

The aim of this study was to summarise existing findings regarding optical coherence tomography (OCT) measurements of ganglion cell layer (GCL) alterations in optic neuritis (ON) and multiple sclerosis (MS). Peer-reviewed studies published prior to April 2016 were searched using PubMed, EMBASE, Web of Science and Scopus. Studies were included if they measured GCL thickness using OCT in patients with either ON, MS or clinically isolated syndrome. For the meta-analysis, we compared GCL thickness in MS patients with and without prior ON, to healthy controls. 42/252 studies were reviewed. In acute ON, studies showed significant thinning of the GCL within the first 5 weeks (n = 5), earlier than retinal nerve fibre layer (RNFL) thinning. GCL thinning at 1-2 months after acute ON predicted visual function at 6 months (n = 3). The meta-analysis showed that the thickness of the GCL was significantly reduced in MS patients both with and without previous ON compared to healthy controls. GCL thinning was associated with visual function in most studies (n = 10) and expanded disability status scale (EDSS) scores (n = 6). In acute ON, thinning of the GCL is measurable prior to RNFL thinning, and GCL thickness after 1-2 months may predict visual function after 6 months. Furthermore, GCL thinning occurs in MS both with and without prior ON, and may be associated with visual function and EDSS score. This suggests that the GCL is a promising biomarker, which may be used to examine in vivo neurodegeneration in ON and MS.

Retinal layer segmentation in multiple sclerosis: a systematic review and meta-analysis

“…Already one month after MSON thinning of the GCIPL becomes quantifiable compared to baseline values, whilst for the pRNFL the advice is to wait at least three months. Reassuringly, this finding is corroborated by a different meta-analysis which also included neuromyelitis optica and which was published whilst present manuscript was under review 76 .…”

Multifocal visual evoked potentials and contrast sensitivity correlate with ganglion cell-inner plexiform layer thickness in multiple sclerosis

“…One limitation of the current study was the lack in MS EyeCARE clinic charts of Expanded Disability Status Scale (EDSS) scores which were shown by some studies to inversely correlate with OCT measurements in MS patients (Petzold et al, 2010, Britze et al, 2017). However, all of our patients (RRMS) were fully ambulatory without obvious disability noted during the exam.…”

Optical coherence tomography in acute optic neuritis: A population-based study

“…[7][8][9] Previous studies have successfully established the principal OCT changes following ON. 12 Ganglion cell layer and RNFL thickness reach steady states after 3-6 months. 10,11 In the corresponding ganglion cell layer, thinning can be detected within the first 2 months after clinical onset.…”