Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

Saidha, Shiv; Syc, Stephanie B.; Durbin, Mary K; Eckstein, Christopher; Oakley, Jonathan D.; Meyer, Scott A.; Conger, Amy; Frohman, Teresa C.; Newsome, Scott D.; Ratchford, John N.; Frohman, Elliot M.; Calabresi, Peter A.

doi:10.1177/1352458511418630

Cited by 248 publications

(230 citation statements)

References 40 publications

(69 reference statements)

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“…We are familiar with the notion that optic neuritis is more than a demyelination state and that substantial neuroaxonal damage may also occur in the patients, as revealed by recent optical coherence tomography (OCT) studies [15][16][17][18][19] . However, while the functional consequence of this neuroaxonal damage was previously established [20][21][22] , demonstrating reduced visual acuity, contrast acuity and visual quality of life, the functional consequence of demyelination was rarely addressed. Our study was aimed to reveal the functional consequences of demyelination in differentiation from axonal loss and develop clinical tools to quantify these functional changes.…”

Section: The Time-constrained Stereo Protocolmentioning

confidence: 99%

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Raz

Hallak

Ben‐Hur

et al. 2014

JoVE

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Section: The Time-constrained Stereo Protocolmentioning

confidence: 99%

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Raz

Hallak

Ben‐Hur

et al. 2014

JoVE

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“…GCL thinning in MS eyes (versus controls), particularly those with a history of ON, was discovered 49 and was consistent with postmortem histological evidence of GCL thinning in all MS subtypes. 50 OCT measurements are starting to be used as part of the data collection in trials of treatments. Patients with MS and healthy controls were followed up for 3 years, measuring multiple ophthalmic items including OCT. 51 About half of the patients with MS were receiving treatment-with b-interferon 1b, b-interferon 1a or glatiramer.…”

Section: Neurodegenerative Diseasementioning

confidence: 99%

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

MacGillivray¹,

Trucco²,

Cameron³

et al. 2014

BJR

109

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imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions. Br J Radiol 2014;87:20130832. REVIEW ARTICLERetinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions 1,2 T J MACGILLIVRAY, MSc ABSTRACTThe black void behind the pupil was optically impenetrable before the invention of the ophthalmoscope by von Helmholtz over 150 years ago. Advances in retinal imaging and image processing, especially over the past decade, have opened a route to another unexplored landscape, the retinal neurovascular architecture and the retinal ganglion pathways linking to the central nervous system beyond. Exploiting these research opportunities requires multidisciplinary teams to explore the interface sitting at the border between ophthalmology, neurology and computing science. It is from the detail and depth of retinal phenotyping that novel metrics and candidate biomarkers are likely to emerge. Confirmation that in vivo retinal neurovascular measures are predictive of microvascular change in the brain and other organs is likely to be a major area of research activity over the next decade. Unlocking this hidden potential within the retina requires integration of structural and functional data sets, that is, multimodal mapping and longitudinal studies spanning the natural history of the disease process. And with further advances in imaging, it is likely that this area of retinal research will remain active and clinically relevant for many years to come. Accordingly, this review looks at state-of-the-art retinal imaging and its application to diagnosis, characterization and prognosis of chronic illness or long-term conditions.Currently about 20 million people in the UK suffer from at least 1 long-term condition (a health problem that cannot be cured but can be controlled by medication or other therapies), and this is set to increase 3-fold over the next decade placing an enormous economic and humanresource strain on the National Health Service.1-3 The retina is unique in the body in allowing easy observation of blood vessels with simple, non-invasive instruments. It is also the only accessible site for studying the central nervous system (CNS) in vivo.4 This makes it a ripe environment for the study of systemic and neurological disease, in a patient-acceptable way. Changes to the retina can occur in some chronic diseases years before other signs become apparent. [5][6][7][8][9] Thus, studying the retina may provide an additional means for clinicians to stratify risk and help identify people who would benefit from early lifestyle changes and preventative therapies, as well as assessing the efficacy of new treatments. In addition, there is some early evidence that certain retinal measures may correlate with disease characterization and also prognosis, which not only provides clinicians with a useful assessment tool but also offers research scientists new avenues to explore in the understanding of the p...

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“…12,13 Briefly, segmentation performed 3-dimensionally identifies the inner limiting membrane, the outer boundaries of the macular RNFL (mRNFL), the inner plexiform layer (IPL), outer plexiform layer, and the inner boundary of the retinal pigment epithelium (figure 1). Thereafter, mRNFL, ganglion cell layer (GCL) 1 IPL, INL 1 outer plexiform layer, and outer nuclear layer (including inner and outer photoreceptor segments) thicknesses were calculated in an annulus (inner radius 5 0.54 mm; outer radius 5 2.4 mm), centered on the fovea.…”

Section: Optical Coherence Tomography Retinal Imaging Was Per-mentioning

confidence: 99%

Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis

Sotirchos

Saidha

et al. 2015

Neurology

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Objective: To assess relationships between spinal cord MRI (SC-MRI) and retinal measures, and to evaluate whether these measures independently relate to clinical disability in multiple sclerosis (MS). Methods:One hundred two patients with MS and 11 healthy controls underwent 3-tesla brain and cervical SC-MRI, which included standard T1-and T2-based sequences and diffusion-tensor and magnetization-transfer imaging, and optical coherence tomography with automated segmentation. Clinical assessments included visual acuity (VA), Expanded Disability Status Scale, MS functional composite, vibration sensation threshold, and hip-flexion strength. Regions of interest circumscribing SC cross-sections at C3-4 were used to obtain cross-sectional area (CSA), fractional anisotropy (FA), perpendicular diffusivity (l t ), and magnetization transfer ratio. Multivariable regression assessed group differences and SC, retinal, and clinical relationships.Results: In MS, there were correlations between SC-CSA, SC-FA, SC-l t , and peripapillary retinal nerve fiber layer (pRNFL) (p 5 0.01, p 5 0.002, p 5 0.001, respectively) after adjusting for age, sex, prior optic neuritis, and brain atrophy. In multivariable clinical models, when SC-CSA, pRNFL, and brain atrophy were included simultaneously, SC-CSA and pRNFL retained independent relationships with low-contrast VA (p 5 0.04, p 5 0.002, respectively), high-contrast VA (p 5 0.06, p 5 0.008), and vibration sensation threshold (p 5 0.01, p 5 0.05). SC-CSA alone retained independent relationships with Expanded Disability Status Scale (p 5 0.001), hip-flexion strength (p 5 0.001), and MS functional composite (p 5 0.004). Conclusions:In this cross-sectional study of patients with MS, correlations exist between SC-MRI and retinal layers, and both exhibit independent relationships with clinical dysfunction. These findings suggest that the SC and optic nerve reflect ongoing global pathologic processes that supplement measures of whole-brain atrophy, highlighting the importance of combining measures from unique compartments to facilitate a thorough examination of regional and global disease processes that contribute to clinical disability in MS. Neurology ® 2015;84:720-728 GLOSSARY BPF 5 brain parenchymal fraction; CSA 5 cross-sectional area; DTI 5 diffusion tensor imaging; DW 5 diffusion weighted; EDSS 5 Expanded Disability Status Scale; FA 5 fractional anisotropy; FOV 5 field of view; GCL 5 ganglion cell layer; HC 5 healthy control; IPL 5 inner plexiform layer; lt 5 perpendicular diffusivity; MLR 5 multivariable linear regression; mRNFL 5 macular retinal nerve fiber layer; MS 5 multiple sclerosis; MSFC 5 multiple sclerosis functional composite; MT 5 magnetization transfer; MTR 5 magnetization transfer ratio; OCT 5 optical coherence tomography; PPMS 5 primary progressive multiple sclerosis; pRNFL 5 peripapillary retinal nerve fiber layer; RNFL 5 retinal nerve fiber layer; ROI 5 region of interest; RSEE 5 robust standard error estimation; SC 5 spinal cord; SPMS 5 secondary progressive mu...

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Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

Cited by 248 publications

References 40 publications

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis

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