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Hong Jiang, Yufeng Ye, Delia Debuc, Meixiao Shen, Byron Lam, Jianhua Wang; Retinal Oximetry in Multiple Sclerosis Assessed With Ultra-high Resolution Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2670.
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Multiple sclerosis (MS) is a devastating neurological disorder affecting young adults. Cerebral hypoperfusion in the normal-appearing white matter of MS patients have been reported. The retinal vasculature has been used as a surrogate for in vivo studies of the CNS microvasculature. The purpose of this project was to determine whether retinal vascular dysfunction occurred in MS using a newly developed slit-lamp adapted ultra-high resolution optical coherence tomography (SL-UHR-OCT).
An algorithm was developed for performing spectral analysis of images obtained with SL-UHR-OCT. A-scans at central wavelengths of 805 and 855 nm of the retinal artery and vein were analyzed for calculating optical density ratios (ODR), representing oxygen saturation in the retinal vessels (Figure 1). Six clinically definite remitting relapsing MS patients and 10 healthy subjects were recruited and imaged. None of these four patients had a history of optic neuritis. The range of their expanded disability status scale (EDSS) was from 1.0 to 1.5. They did not have other medical problems other than MS. All of them were on Rebif. Both eyes of MS patients and normal controls were scanned at the same visit.
ODR of the artery was 0.07 ± 0.81 (mean ± SD) in MS patients, significantly lower than that in healthy control (0.87 ± 0.57, P = 0.03). ODR of the vein was -0.08 ± 0.57 in MS, which was not significantly different compared to healthy controls 0.20 ± 0.38, P = 0.33). The usage of oxygen (ODR difference between artery and vein) was -0.01 ± 0.52 in MS, which was significantly lower than that (0.67 ± 0.63, P = 0.02) of normal controls.
We demonstrated that oxygen saturation levels of the retinal artery were lower in MS compared to normal controls, possibly indicating retinal hypoperfusion in MS patients. Further studies will be needed to correlate the ocular findings to brain hypoperfusion with a large scale of sample size.
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