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Liang Liu, Spain Rebecca, Yali Jia, Xinbo Zhang, Ou Tan, David Huang; Optic Nerve Head Perfusion and Retinal Structural Measurement by Optical Coherence Tomography in Multiple Sclerosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4218.
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© ARVO (1962-2015); The Authors (2016-present)
We performed a retrospective, observational study to examine optic nerve head (ONH) perfusion, retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness using 1050-nm swept-source optical coherence tomography (SS-OCT) in multiple sclerosis (MS), with and without history of acute optic neuritis (ON).
Using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm, a 3x3 mm volumetric angiogram centered on the ONH was scanned to measure ONH perfusion. The ONH flow index was defined as the average decorrelation value on the en face angiogram in ONH. Two 8x8 mm volumetric scans centered on the ONH and fovea were captured. RNFL thickness was measured from a circular profile of 3.4mm diameter centered on the ONH. GCC thickness was measured from a circle of 7mm diameter centered on the fovea exclude the ONH. Mann–Whitney test was used to compare these variables between MS patients and healthy control (HC). The area under the receiver-operating-characteristic-curve (AROC) was used to test diagnostic power of each parameter. Logistic regression was employed to investigate the AROC of combined parameters.
Seventy eyes of 45 MS patients and 55 eyes of 32 HC participants were analyzed, including 43 eyes in MS non-ON group, and 27 eyes with ON (MS ON group).The MS non-ON eyes had reduced ONH flow index, GCC thickness and NFL thickness (mean±SD, 0.154±0.020, 100.8±7.8 µm and 108.4±12.3 µm, respectively) compared with HC eyes (0.163±0.013 P=0.04, 104.8±8.2µm P=0.02 and 118.3±10.7µm P<0.001, respectively). The MS ON eyes had reduced ONH flow index, GCC thickness and NFL thickness (0.139±0.020, 89.0±12.0µm and 98.0±17.4µm, respectively) compared with MS non-ON eyes (P=0.002, P<0.001and P=0.017, respectively). The AROC for HC versus MS ON eyes were 0.849, 0.854 and 0.819 for ONH flow index, GCC thickness and NFL thickness, respectively. The highest AROC (0.942) was achieved by the combination of the three variables, which is significantly improved (P=0.042) compared with the AROC (0.866) of GCC and NFL thickness combination.
Reductions in ONH perfusion, GCC and NFL thickness could be detected in MS eyes with or without a previous history of ON. The combination of the functional and structural parameters significantly enhanced the ability to diagnose damage from past ON and may serve as a useful biomarker of optic nerve damage in MS.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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