Retinal nerve fiber layer loss in multiple system atrophy

Fischer, Manuel; Synofzik, Matthis; Heidlauf, Robert; Schicks, Julia; Srulijes, Karin; Kernstock, Christoph; Berg, Daniela; Schöls, Lüdger; Schiefer, Ulrich

doi:10.1002/mds.23523

Cited by 25 publications

(23 citation statements)

References 6 publications

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“…The first OCT study in patients with MSA (53) included 10 patients with MSA and 10 age-matched controls. The average peripapillary RNFL (RNFL) (in circular B-scans centered in optic disk) and the total retinal thickness (in two linear B-scans at the foveola) were studied.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the authors found no association between any OCT measurements, and visual field abnormalities, disease severity as measured by the United Multiple System Atrophy Rating Scale (UMSARS), and disease duration. It is unclear if, in this study, the authors included data of patients from their 2011 study (53). …”

Section: Resultsmentioning

confidence: 99%

“…In this regard, the acquisition protocol of macular measurements (e.g., image resolution, number and dimension of slices, analyzed areas from those slices, layers analyzed, and segmentation methods) varied considerably among studies, and in some studies certain macular measurements were not reported.The statistical analysis of the OCT results was markedly different: most studies averaged the results of both eyes (51, 54–56); two considered the results of each eye as independent values (50, 52), whereas one study used only the results of the right eye (53). …”

Section: Resultsmentioning

confidence: 99%

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The Retina in Multiple System Atrophy: Systematic Review and Meta-Analysis

et al. 2017

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BackgroundMultiple system atrophy (MSA) is a rare, adult-onset, rapidly progressive fatal synucleinopathy that primarily affects oligodendroglial cells in the brain. Patients with MSA only rarely have visual complaints, but recent studies of the retina using optical coherence tomography (OCT) showed atrophy of the peripapillary retinal nerve fiber layer (RNFL) and to a lesser extent the macular ganglion cell layer (GCL) complex.MethodsWe performed a literature review and meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses guidelines for studies published before January 2017, identified through PubMed and Google Scholar databases, which reported OCT-related outcomes in patients with MSA and controls. A random-effects model was constructed.ResultsThe meta-analysis search strategy yielded 15 articles of which 7 met the inclusion criteria. The pooled difference in the average thickness of the RNFL was −5.48 μm (95% CI, −6.23 to −4.73; p < 0.0001), indicating significant thinning in patients with MSA. The pooled results showed significant thinning in all the specific RNFL quadrants, except in the temporal RNFL quadrant, where the thickness in MSA and controls was similar [pooled difference of 1.11 µm (95% CI, −4.03 to 6.26; p = 0.67)]. This pattern of retinal damage suggests that MSA patients have preferential loss of retinal ganglion cells projecting to the magnocellular pathway (M-cells), which are mainly located in the peripheral retina and are not essential for visual acuity. Visual acuity, on the other hand, relies mostly on macular ganglion cells projecting to the parvocellular pathway (P-cells) through the temporal portion of the RNFL, which are relatively spared in MSA patients.ConclusionThe retinal damage in patients with MSA differs from that observed in patients with Parkinson disease (PD). Patients with MSA have more relative preservation of temporal sector of the RNFL and less severe atrophy of the macular GCL complex. We hypothesize that in patients with MSA there is predominant damage of large myelinated optic nerve axons like those originating from the M-cells. These large axons may require higher support from oligodendrocytes. Conversely, in patients with PD, P-cells might be more affected.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Retina in Multiple System Atrophy: Systematic Review and Meta-Analysis

et al. 2017

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“…Spectral domain optical coherence tomography (SD-OCT) SD-OCT imaging was done as previously described [8]. Briefly, patients were subjected to SD-OCT using the commercially available Spectralis® HRA+OCT device (Heidelberg Engineering, Heidelberg, Germany).…”

Section: Patientsmentioning

confidence: 99%

“…This technology is ideally suited for sensitive longitudinal analyses of suspected retinal nerve fiber layer (RNFL) loss after ODH in glaucoma patients. SD-OCT reveals structural changes in the RNFL by automatic segmentation [8] and provides immediate data on the distribution and structural integrity of the retinal nerve fiber tissue [9]. Furthermore, previous studies have demonstrated that such data correlate with the visual function in glaucoma [10].…”

Section: Introductionmentioning

confidence: 97%

Optical coherence tomography shows progressive local nerve fiber loss after disc hemorrhages in glaucoma patients

Kernstock

Dietzsch

Januschowski

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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An Eye on Movement Disorders

Wilson

Hallett

Anderson

2021

Movement Disord Clin Pract

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Eye disorders spanning a range of ocular tissue are common in patients with movement disorders. Highlighting these ocular manifestations will benefit patients and may even aid in diagnosis. In this educational review we outline the anatomy and function of the ocular tissues with a focus on the tissues most affected in movement disorders. We review the movement disorders associated with ocular pathology and where possible explore the underlying cellular basis thought to be driving the pathology and provide a brief overview of ophthalmic investigations available to the neurologist. This review does not cover intracranial primary visual pathways, higher visual function, or the ocular motor system.

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Retinal nerve fiber layer loss in multiple system atrophy

Cited by 25 publications

References 6 publications

The Retina in Multiple System Atrophy: Systematic Review and Meta-Analysis

The Retina in Multiple System Atrophy: Systematic Review and Meta-Analysis

Optical coherence tomography shows progressive local nerve fiber loss after disc hemorrhages in glaucoma patients

An Eye on Movement Disorders

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