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Lucy T Xu, Robert A Bermel, Amy Nowacki, Peter K Kaiser; Optical Coherence Tomography in Multiple Sclerosis Patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5774.
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© ARVO (1962-2015); The Authors (2016-present)
Do multiple sclerosis (MS) patients with optic neuritis exhibit differences in OCT, functional, and/or visual acuity measures compared to MS patients without optic neuritis and healthy controls?
Prospective case-control study of 30 MS-optic neuritis patients, 22 MS-non optic neuritis patients and 24 healthy controls. Full contrast visual acuity (FCVA), 2.5% and 1.25% Sloan low contrast visual acuity (LCVA), Visual Functioning Questionnaire-25 (VFQ-25), Multiple Sclerosis Performance Scale (MSPS) scores, and Cirrus HD-OCT and Spectralis HRA+OCT scans in both the peripapillary and macular regions were obtained.
Optic neuritis eyes exhibited thinner average peripapillary retinal nerve fiber layer (RNFL), papillomacular bundle (PMB), ganglion cell + inner plexiform layer (IPL), macular RNFL and average macular thickness compared to MS eyes without optic neuritis and healthy controls. The macular volumes of optic neuritis eyes were also significantly less. Total macular volume, central subfield thickness, and nasal and temporal RNFL measurements were statistically different (p < 0.03 ) between Cirrus and Spectralis while average peripapillary RNFL thickness did not differ significantly (p = 0.24). We show that PMB and ganglion cell + IPL are equally and significantly correlated with 2.5% LCVA (r= 0.54). Ganglion cell + IPL thickness seems to correlate more highly than PMB with 1.25% LCVA. However, in subjective measures of visual function (VFQ-25 and MSPS vision subscore), PMB correlates more highly than ganglion cell + IPL. We found PMB thickness to be the best predictor in discriminating between optic neuritis and non-optic neuritis eyes in MS patients while visual acuities were rather poor predictors.
The structural differences seen in optic neuritis eyes correlates well with functional changes in visual acuity, and quality of life as it relates to vision. Also, there exist discrepancies in various OCT measurements across machine types due to scan patterns and/or segmentation algorithms. In MS patients, optic neuritis eyes can be differentiated from non-optic neuritis eyes using PMB thickness. This work exhibits the unique and important role of OCT in understanding optic neuritis and multiple sclerosis. Further studies will continue to improve the utility of OCT in clinical and research settings.
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