Retinal Imaging by Laser Polarimetry and Optical Coherence Tomography Evidence of Axonal Degeneration in Multiple Sclerosis

Zaveri, Maulik; Conger, Amy; Salter, Amber; Frohman, Teresa C.; Galetta, Steven; Markowitz, Clyde; Jacobs, Dina; Cutter, Gary; Ying, Gui Shuang; Maguire, Maureen G.; Calabresi, Peter A.; Balcer, Laura J.; Frohman, Elliot M.

doi:10.1001/archneur.65.7.924

Cited by 123 publications

(103 citation statements)

References 31 publications

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“…Notwithstanding these differences, we have confirmed that OCT and GDx metrics yield very similar findings with respect to visual loss in patients with MS who have ON [17]. Like OCT, GDx produces measures that correlate with performance on low-contrast letter acuity and with changes in visual field; however, GDx can additionally detect abnormalities even when they are highly restricted to a particular distribution.…”

Section: The Future Of Retinal Imaging In Mssupporting

confidence: 68%

“…GDx, which is based on the projection of polarized light and its retardation when propagating through a birefringent medium (such as the RNFL), can be used to measure both the thickness and the integrity of the nerve fiber layer [17]. The physical properties of this technology enable the retinal substructure to be examined in order to assess the integrity of axonal microtubules.…”

Section: The Future Of Retinal Imaging In Msmentioning

confidence: 99%

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Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

et al. 2011

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Summary: Axonal and neuronal degeneration are important features of multiple sclerosis (MS) and other neurologic disorders that affect the anterior visual pathway. Optical coherence tomography (OCT) is a non-invasive technique that allows imaging of the retinal nerve fiber layer (RNFL), a structure which is principally composed of ganglion cell axons that form the optic nerves, chiasm, and optic tracts. Since retinal axons are nonmyelinated until they penetrate the lamina cribrosa, the RNFL is an ideal structure (no other central nervous system tract has this unique arrangement) for visualizing the processes of neurodegeneration, neuroprotection and, potentially, even neuro-repair. OCT is capable of providing high-resolution reconstructions of retinal anatomy in a rapid and reproducible fashion and permits objective analysis of the RNFL (axons) as well as ganglion cells and other neurons in the macula. In a systematic OCT examination of multiple sclerosis (MS) patients, RNFL thickness and macular volumes are reduced when compared to disease-free controls.Conspicuously, these changes, which signify disorganization of retinal structural architecture, occur over time even in the absence of a history of acute demyelinating optic neuritis. RNFL axonal loss in MS is most severe in those eyes with a corresponding reduction in low-contrast letter acuity (a sensitive vision test involving the perception of gray letters on a white background) and in those patients who exhibit the greatest magnitude of brain atrophy, as measured by validated magnetic resonance imaging techniques. These unique structure-function correlations make the anterior visual pathway an ideal model for investigating the effects of standard and novel therapies that target axonal and neuronal degeneration. We provide an overview of the physics of OCT, its unique properties as a non-invasive imaging technique, and its potential applications toward understanding mechanisms of brain tissue injury in MS, other optic neuropathies, and neurologic disorders.

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Section: The Future Of Retinal Imaging In Mssupporting

confidence: 68%

Section: The Future Of Retinal Imaging In Msmentioning

confidence: 99%

Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

et al. 2011

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“…32 These results support validity for RNFL thickness as a marker for axonal degeneration and support use of these techniques in clinical trials that examine neuroprotective and other disease-modifying therapies.…”

Section: Clinical Studies Using Gdx Vcc Technologysupporting

confidence: 61%

Evaluation of Retinal Nerve Fiber Layer using Scanning Laser Polarimetry

Sharma¹,

Sobti²,

Wadhwani³

et al. 2010

JOCGP

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Early diagnosis of glaucoma requires evaluation of the retinal nerve fiber layer (RNFL) to pick-up subtle changes before visual field defects. Scanning laser polarimetry using the GDx VCC offers a unique tool for imaging of RNFL changes in glaucoma. It is useful for early diagnosis and also to detect progression of glaucoma. The following review covers the basic principles, interpretation, clinical utility of this technology and reviews the literature on its current applications.

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“…Prior attempts to quantify RNFL loss and to monitor multiple sclerosis patients have almost exclusively been with time-domain OCT (TDOCT). 1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition to having a significantly lower axial resolution, TDOCT has limited image acquisition, retinal segmentation, and precise long-term monitoring capabilities. On the other hand, spectral-domain OCT (SDOCT), the newest iteration of OCT technology, is characterized by markedly increased image acquisition speed and improved axial resolution, among other features, and has been increasingly utilized for evaluation of a variety of ocular diseases, such as glaucoma, age-related macular degeneration, macular hole, epiretinal membrane, and diabetic macular edema.…”

Section: Introductionmentioning

confidence: 99%

Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography

Khanifar

Parlitsis

Ehrlich

et al. 2010

OPTH

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Purpose: Histopathologic studies have reported retinal nerve fiber layer (RNFL) thinning in various neurodegenerative diseases. Attempts to quantify this loss in vivo have relied on time-domain optical coherence tomography (TDOCT), which has low resolution and requires substantial interpolation of data for volume measurements. We hypothesized that the significantly higher resolution of spectral-domain optical coherence tomography (SDOCT) would better detect RNFL changes in patients with multiple sclerosis, and that RNFL thickness differences between eyes with and without optic neuritis might be identified more accurately. Methods: In this retrospective case series, patients with multiple sclerosis were recruited from the Judith Jaffe Multiple Sclerosis Center at Weill Cornell Medical College in New York. Patients with a recent clinical diagnosis of optic neuritis (less than three months) were excluded. Eyes with a history of glaucoma, optic neuropathy (other than multiple sclerosis-related optic neuritis), age-related macular degeneration, or other relevant retinal and/or optic nerve disease were excluded. Both eyes of each patient were imaged with the Heidelberg Spectralis ® HRA + OCT. RNFL and macular thickness were measured for each eye using the Heidelberg OCT software. These measurements were compared with validated published normal values, and were modeled as linear functions of duration of disease. The odds of an optic neuritis diagnosis as a function of RNFL and macular thickness were calculated. Results: Ninety-four eyes were prospectively evaluated using OCT. Ages of patients ranged from 26 to 69 years, with an average age of 39 years. Peripapillary RNFL thinning was demonstrated in multiple sclerosis patients; mean RNFL thickness was 88.5 µm for individuals with multiple sclerosis compared with a reported normal value of 97 µm (P , 0.001). Eyes with a history of optic neuritis had more thinning compared with those without optic neuritis (83.0 µm versus 90.5 µm, respectively, P = 0.02). No significant differences were observed in macular thickness measurements between eyes with and without optic neuritis, nor were macular thickness measurements significantly different from normal values. As a function of multiple sclerosis duration and controlling for age, RNFL thickness was decreased in patients with a duration of multiple sclerosis greater than five years compared with those with a duration less than or equal to one year (P = 0.008). Conclusions:Patients with a history of multiple sclerosis had RNFL thinning that was detectable on SDOCT. Decreasing RNFL thickness in eyes with optic neuritis was found, and the odds of having optic neuritis were increased significantly with decreasing RNFL thickness. Average RNFL thinning with increasing duration of disease was an excellent predictor of a reported history of optic neuritis. SDOCT retinal imaging may represent a high-resolution, objective, noninvasive, and easily quantifiable in vivo biomarker of the presence of optic neuritis and severity of multiple s...

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Retinal Imaging by Laser Polarimetry and Optical Coherence Tomography Evidence of Axonal Degeneration in Multiple Sclerosis

Cited by 123 publications

References 31 publications

Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

Optical Coherence Tomography (OCT): Imaging the Visual Pathway as a Model for Neurodegeneration

Evaluation of Retinal Nerve Fiber Layer using Scanning Laser Polarimetry

Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography

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