Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study

Oertel, Frederike Cosima; Havla, Joachim; Roca-Fernández, Adriana; Lizak, Nathaniel; Zimmermann, Hanna; Motamedi, Seyedamirhosein; Borisow, Nadja; White, Owen; Bellmann‐Strobl, Judith; Albrecht, Philipp; Ruprecht, Klemens; Jarius, Sven; Palace, Jacqueline; Leite, Maria Isabel; Kuempfel, Tania; Paul, Friedemann; Brandt, Alexander U.

doi:10.1136/jnnp-2018-318382

Cited by 87 publications

(97 citation statements)

References 39 publications

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“…Note that in this study optic nerve diameters were measured in the cisternal segment 7 mm anterior to the OC, since contrast heterogeneity and motion artifacts in the orbital part rendered orbital assessment difficult in 25% of the patients. The observation that smaller OC dimensions were also found in NMOSD-NON (compared to HC and NMOSD-ON) supports microstructural changes in the optic pathway independent of ON [26], which have been described in NMOSD [5,27,43,44]. In concordance with a study by Harrigan et al [16], the optic nerve diameter was smaller in patients with a history of ON compared to HC but not in patients without ON.…”

Section: Discussionsupporting

confidence: 89%

Optic chiasm measurements may be useful markers of anterior optic pathway degeneration in neuromyelitis optica spectrum disorders

Juenger

Cooper²,

Chien

et al. 2020

Eur Radiol

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Objectives We aimed to evaluate optic chiasm (OC) measures as potential imaging marker for anterior optic pathway damage assessment in the context of neuromyelitis optica spectrum disorders (NMOSD). Materials and method This cross-sectional study included 39 patients exclusively with aquaporin 4-IgG seropositive NMOSD of which 25 patients had a history of optic neuritis (NMOSD-ON) and 37 age-and sex-matched healthy controls (HC). OC heights, width, and area were measured using standard 3D T1-weighted MRI. Sensitivity of these measures to detect neurodegeneration in the anterior optic pathway was assessed in receiver operating characteristics analyses. Correlation coefficients were used to assess associations with structural measures of the anterior optic pathway (optic nerve dimensions, retinal ganglion cell loss) and clinical measures (visual function and disease duration). Results OC heights and area were significantly smaller in NMOSD-ON compared to HC (NMOSD-ON vs. HC p < 0.0001). An OC area smaller than 22.5 mm 2 yielded a sensitivity of 0.92 and a specificity of 0.92 in separating chiasms of NMOSD-ON from HC. OC area correlated well with structural and clinical measures in NMOSD-ON: optic nerve diameter (r = 0.4, p = 0.047), peripapillary retinal nerve fiber layer thickness (r = 0.59, p = 0.003), global visual acuity (r = − 0.57, p = 0.013), and diseases duration (r = − 0.5, p = 0.012). Conclusion Our results suggest that OC measures are promising and easily accessible imaging markers for the assessment of anterior optic pathway damage.

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Section: Discussionsupporting

confidence: 89%

Optic chiasm measurements may be useful markers of anterior optic pathway degeneration in neuromyelitis optica spectrum disorders

Juenger

Cooper²,

Chien

et al. 2020

Eur Radiol

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“…In line with the clinical experience that disability is almost exclusively attack-related in NMOSD, some studies did not find progressive retinal thinning independent of ON (258). However, recent work has suggested that there is attack-independent ganglion cell loss in NMOSD-a finding whose clinical relevance needs to be further investigated (259). In addition, foveal changes have been detected in NMOSD patients without clinical evidence of optic neuritis of affection of the visual system, which suggests that AQP4 ab may directly target astrocytic Mueller cells in the retina, thus causing a primary retinal astrocytopathy (188,260,261).…”

Section: Neuromyelitis Optica Spectrum Disorders (Nmosd)mentioning

confidence: 86%

Visualizing the Central Nervous System: Imaging Tools for Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Kuchling

Paul

2020

Front. Neurol.

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“…33 We recently reported progressive GCIPL loss without ON in a longitudinal study investigating an overlapping cohort. 34 Further evidence for a primary retinopathy comes from Tian et al 35 reporting inner retinal layer thinning independent from ON. Significant changes in vascularization of the fovea were also shown in patients with AQP4-IgG-seropositive NMOSD in comparison to HCs using OCT angiography.…”

Section: Discussionmentioning

confidence: 99%

Altered fovea in AQP4-IgG–seropositive neuromyelitis optica spectrum disorders

Motamedi

Oertel

Yadav

et al. 2020

Neurol Neuroimmunol Neuroinflamm

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ObjectiveTo investigate disease-specific foveal shape changes in patients with neuromyelitis optica spectrum disorders (NMOSDs) using foveal morphometry.MethodsThis cross-sectional study included macular spectral domain optical coherence tomography scans of 52 eyes from 28 patients with aquaporin-4 immunoglobulin G (AQP4-IgG)-seropositive NMOSD, 116 eyes from 60 patients with MS, and 123 eyes from 62 healthy controls (HCs), retrospectively, and an independent confirmatory cohort comprised 33/33 patients with NMOSD/MS. The fovea was characterized using 3D foveal morphometry. We included peripapillary retinal nerve fiber layer (pRNFL) thickness and combined macular ganglion cell and inner plexiform layer (GCIPL) volume to account for optic neuritis (ON)-related neuroaxonal damage.ResultsGroup comparison showed significant differences compared with HC in the majority of foveal shape parameters in NMOSD, but not MS. Pit flat disk area, average pit flat disk diameter, inner rim volume, and major slope disk length, as selected parameters, showed differences between NMOSD and MS (p value = 0.017, 0.002, 0.005, and 0.033, respectively). This effect was independent of ON. Area under the curve was between 0.7 and 0.8 (receiver operating characteristic curve) for discriminating between NMOSD and MS. Pit flat disk area and average pit flat disk diameter changes independent of ON were confirmed in an independent cohort.ConclusionsFoveal morphometry reveals a wider and flatter fovea in NMOSD in comparison to MS and HC. Comparison to MS and accounting for ON suggest this effect to be at least in part independent of ON. This supports a primary retinopathy in AQP4-IgG–seropositive NMOSD.

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Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study

Cited by 87 publications

References 39 publications

Optic chiasm measurements may be useful markers of anterior optic pathway degeneration in neuromyelitis optica spectrum disorders

Optic chiasm measurements may be useful markers of anterior optic pathway degeneration in neuromyelitis optica spectrum disorders

Visualizing the Central Nervous System: Imaging Tools for Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Altered fovea in AQP4-IgG–seropositive neuromyelitis optica spectrum disorders

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