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Lu Cheng, Qiuhai Lin, Zhenfen Ling, Xun Xu; Retinal Structural Changes as A Promising Biomarker of Neuromyelitis Optica Associated Optic Neuritis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5077.
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© ARVO (1962-2015); The Authors (2016-present)
We detected retinal structural changes in neuromyelitis optica associated optic neuritis (NMO-ON) patients compared with multiple sclerosis associated optic neuritis (MS-ON) patients by optical coherence tomography (OCT), and evaluated their correlations to cerebral spinal fluid (CSF) biomarkers to investigate the role of retinal structural markers in diagnosis and monitoring of NMO-ON.
In this cross-sectional study 31 (58 eyes) NMO-ON patients, 38 (38 eyes) MS-ON patients and 40 (80 eyes) healthy controls (HCs) were evaluated. Parapapillary retinal nerve fiber layer (pRNFL) and segmented macular layers were evaluated with Spectralis OCT. Best-corrected visual acuity (BCVA) of all subjects were assessed. We tested the CSF samples from 20 NMO-ON patients and 19 MS-ON patients as well. Anti-aquaporin 4 (anti-AQP4) antibody was detected by indirect immunofluorescence. Interleukin (IL)-6 and glial fibrillary acidic protein (GFAP),a biomarker of astrocytic injuries, were detected by ELISA.
Compared with healthy control eyes, both NMO-ON and MS-ON eyes showed significant decrease of pRNFL thickness. Thinning of RNFL and the ganglion cell layer plus the inner plexiform layer (GCL+IPL) at all inner and outer macular regions were also detected in NMO-ON and MS-ON eyes. Besides, NMO-ON patients had a thinner pRNFL and macular GCL+IPL than MS-ON patients. Moreover, the CSF anti-AQP4 antibody, IL-6 and GFAP levels of NMO-ON patients were significantly higher than that of MS-ON patients. Although pRNFL thickness had no significant association with CSF anti-AQP4 antibody titres, it had a correlation to CSF IL-6 (r = 0.57, p < 0.02) and GFAP level (r= 0.63, p < 0.01) in NMO-ON patients. There was a correlation between pRNFL thickness and BCVA (r = 0.57, p < 0.0001) in NMO-ON patients as well.
The current study revealed a notable difference in the optic disc RNFL thickness and segmented macular layers among NMO-ON, MS-ON and normal eyes, and demonstrated the correlation between retinal structural changes and CSF biomarkers in NMO-ON patients as well. It indicated that the retinal structural changes detected by OCT may be a promising method to distinguish the aetiology of ON and a novel noninvasive biomarker to observe and monitor central nerve system pathophysiological progress, especially astrocytopathy, of NMO-ON.
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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