Usefulness of optic nerve ultrasound to predict clinical progression in multiple sclerosis

Sánchez, S. Pérez; Madueño, Sara Eichau; Hidalgo, M. Rus; Mayoral, Ana; Vilches‐Arenas, Ángel; Mascarell, G. Navarro; Izquierdo, Guillermo

doi:10.1016/j.nrleng.2017.12.010

Cited by 5 publications

(13 citation statements)

References 24 publications

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“…Our data also confirm recent studies that TOS demonstrates optic nerve atrophy regardless of the presence of prior ON (Candeliere Merlicco et al, ; Pérez Sánchez, ). However, this was the least sensitive of the three techniques to detect MS patients from healthy controls as demonstrated by the AUC values in the ROC curve (AUC of LD: 0.532; TD: 0.534).…”

Section: Discussionsupporting

confidence: 92%

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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Section: Discussionsupporting

confidence: 92%

Functional and structural changes in the visual pathway in multiple sclerosis

et al. 2019

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“…Of these, 63 studies were excluded (31 duplicate data, 27 not studying breastfeeding, 2 review articles, 2 lacking a comparison group, and 1 not studying relapses) and 24 studies (2974 women) were included in the review. 8,[10][11][12][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Some well-known studies of breastfeeding were excluded 6,38,39 owing to duplicate data on the same patients as included studies. 8,21,35 Of the 24 studies, 16 were included in the quantitative meta-analysis 8,[10][11][12]20,21,[23][24][25][26][27][30][31][32]35,37 these included the required data or the data were provided by authors.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were excluded from the metaanalysis owing to lack of data. 18,19,22,28,29,33,34,36 Agreement between reviewers for eligibility was noted at both abstract (Cohen κ = 0.90) and full-text (Cohen κ = 0.89) review. Characteristics of the 24 studies are presented in the eTable in the Supplement.…”

Section: Resultsmentioning

confidence: 99%

Association Between Breastfeeding and Postpartum Multiple Sclerosis Relapses

et al. 2020

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IMPORTANCE Multiple sclerosis (MS) relapses may be increased in the postpartum period, and whether breastfeeding is associated with reduction in the risk of postpartum relapses remains controversial.OBJECTIVE To perform a systematic review and meta-analysis to evaluate whether breastfeeding is associated with reduction in postpartum MS relapses compared with not breastfeeding.DATA SOURCES PubMed and Embase were searched for studies assessing the association between breastfeeding and MS disease activity published between January 1, 1980, and July 11, 2018, as well as reference lists of selected articles.STUDY SELECTION All study designs assessing the association between breastfeeding and postpartum relapses in MS relative to a comparator group were included. DATA EXTRACTION AND SYNTHESISStudy eligibility assessment and extraction of study characteristics, methods, and outcomes, were performed independently by 2 reviewers following PRISMA guidelines. Risk of bias was evaluated by 2 independent reviewers with the ROBINS-I tool for nonrandomized, interventional studies. Findings from studies with data available for the number of women with postpartum relapses in the breastfeeding and nonbreastfeeding groups were combined with a random-effects model. MAIN OUTCOMES AND MEASURES Postpartum MS relapse. RESULTSThe search identified 462 unique citations, and 24 (2974 women) satisfied eligibility criteria and were included, of which 16 were included in the quantitative meta-analysis. The pooled summary odds ratio for the association of breastfeeding with postpartum relapses was 0.63 (95% CI, 0.45-0.88; P = .006) compared with a reference of nonbreastfeeding. Pooled adjusted hazard ratio across 4 studies that reported this finding was 0.57 (95% CI, 0.38-0.85; P = .006). There was moderate heterogeneity (I 2 = 48%), which was explained by variable prepregnancy relapse rate, postpartum follow-up duration, and the publication year. A stronger association was seen in studies of exclusive rather than nonexclusive breastfeeding, although both demonstrated an association. Studies were rated at moderate and serious risk of bias, with concern for residual confounding, although sensitivity analysis including only moderate quality studies was consistent with a protective outcome of breastfeeding.CONCLUSIONS AND RELEVANCE These findings suggest that breastfeeding is protective against postpartum relapses in MS, although high-quality prospective studies to date are limited and well-designed observational studies that aim to emulate a randomized trial would be of benefit.

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“…Therefore, early diagnosis of optic nerve damage is extremely important. Recently, ultrasonography has become an important adjuvant in the evaluation of the optic nerve 16 . We performed this study considering that SWE can be an effective modality for evaluating the optic nerve in the diagnosis of optic neuritis because of non‐invasive and low‐cost properties.…”

Section: Discussionmentioning

confidence: 99%

“…Optic neuritis may cause increased or decreased ONSD in the acute and chronic phases 16,26,27 . This may be an early and late sign of optic neuritis.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the optic nerve, optic disc, and perineural area using shear‐wave elastography in patients with multiple sclerosis

et al. 2021

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Purpose: To observe and describe the stiffness changes of the optic nerve in the patients with multiple sclerosis (MS) with or without optic neuritis and healthy adults via shear wave elastography (SWE).Methods: 70 optic nerves from 35 patients with MS and 60 optic nerves from 30 healthy subjects were included prospectively in the study. The optic nerve (ON), optic disc (OD), and perineural area were evaluated with SWE and optic nerve sheat diameter (ONSD) was measured by ultrasound. Results:The mean age of patients was 39.68 ± 9.99 years. There was no statistically significant difference between the groups in terms of ONSD, SWE ON, SWE OD, and SWE perineural area levels (P > .05). In the MS group; No statistically significant difference was found between patients with and without optic neuritis for the mean age, gender distribution, duration of MS, types of MS, ONSD, SWE ON, SWE OD, SWE perineural area, and Expanded Disability Status Scale (EDSS) scores (P > .05).No statistically significant difference in terms of ONSD, SWE ON, SWE OD, and SWE perineural area between the MS patients with or without optic neuritis and the control group (P > .05). Conclusion:Shear wave elastography measurements of the optic nerve, optic disc, and perineural area do not contribute to the evaluation of optic neuritis in a patient with MS.

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Usefulness of optic nerve ultrasound to predict clinical progression in multiple sclerosis

Cited by 5 publications

References 24 publications

Functional and structural changes in the visual pathway in multiple sclerosis

Functional and structural changes in the visual pathway in multiple sclerosis

Association Between Breastfeeding and Postpartum Multiple Sclerosis Relapses

Assessment of the optic nerve, optic disc, and perineural area using shear‐wave elastography in patients with multiple sclerosis

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