April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
One Month Findings Predict Retinal Nerve Fiber Layer (RNFL) Loss at 6 Months After Acute Optic Neuritis
Author Affiliations & Notes
  • S. C. Anderson
    Ophthalmology & Visual Sciences, VA Medical Center & Univ of Iowa, Iowa City, Iowa
  • M. J. Kupersmith
    Ophthalmology, Roosevelt Hospital & New York Eye and Ear Infirmary, New York, New York
  • G. Mandel
    Ophthalmology, Roosevelt Hospital & New York Eye and Ear Infirmary, New York, New York
  • R. Kardon
    Ophthalmology & Visual Sciences, VA Medical Center & Univ of Iowa, Iowa City, Iowa
  • Footnotes
    Commercial Relationships  S.C. Anderson, None; M.J. Kupersmith, Teva Pharmaceutical, C; G. Mandel, None; R. Kardon, None.
  • Footnotes
    Support  Supported by a Veterans Affairs Merit Rehab Grant and Pearle Vision Fun
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 926. doi:
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    • Get Citation

      S. C. Anderson, M. J. Kupersmith, G. Mandel, R. Kardon; One Month Findings Predict Retinal Nerve Fiber Layer (RNFL) Loss at 6 Months After Acute Optic Neuritis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):926.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : We reported that in acute optic neuritis, RNFL shows acute swelling in greater than 80% sectors at baseline and thinning in greater than 50% of sectors at 1 month (ARVO 2008). We now report the 3 & 6 month RNFL outcomes of this first prospective study on patients followed from the onset of acute optic neuritis.

Methods: : 35 subjects had visual & RNFL assessments using OCT 3 and scanning laser polarimetry (SLP; enhanced corneal compensation) at entry, 1, 3 & 6 months. We judged acuity worse than 20/50 or mean deviation (MD) worse than -15 db as severe vision loss. RNFL thinning for OCT & SLP was significant if 2 clock-hour sectors were 10 microns less than in fellow normal eyes.

Results: : RNFL sectors were thinned by SLP in 53% & 76% and by OCT in 73% and 87% of eyes at 3 & 6 months, respectively. Severe vision loss & sector thinning at 1 month correlated with thinning of the OCT average RNFL at 6 months(r=.58, p=.006 & r=.54, p=0.02). The graphs show sector and mean RNFL loss (compared to fellow eyes) over time. Note swelling of RNFL, common at entry & 1 month, precludes demonstration of early loss at one month. At 6 months, OCT mean RNFL thinning correlated with visual acuity (r=.653, p=.001) and MD (r=.725, p=.0001) assessed at that time point.

Conclusions: : Sector analysis with fellow eye comparison shows RNFL thinning is common in optic neuritis, particularly when visual deficits persist. Eyes with severe vision loss or RNFL thinning at 1 month have worse RNFL loss that continues passed 3 months. This corroborates the importance of the 1 month time point after an acute optic neuritis.

Keywords: nerve fiber layer • visual fields 
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