Abstract
Purpose: :
To describe anatomic and functional features of multiple sclerosis patients by Standard Automated Perimetry, high-speed Fourier-Domain optical coherence tomography (FD-OCT) and Fundus Microperimetry.
Methods: :
In a prospective study, twenty consecutive patients ( 40 eyes of which 10 eyes with optic neuritis history), ranged in age from 21 to 58 years (mean ± SD: 35,8±10,67) with multiple sclerosis underwent best corrected visual acuitydetermination, Humphrey visual field (HVF), Fundus Microperimetry ( MP1, Nidek Inc, Italy), RTVue FD-OCT (Optovue, Fremont, CA, USA). Main outcome measures were fixation stability and position and mean retinal sensitivities within the 4 central degrees areas. Foveal thickness and Ganglion cell complex (GCC) thickness were measured by RTVue FD-OCT.
Results: :
LogMAR BCVA ± SD was 0,05 ± 0,1. Fixation was central in 36 eyes (90%) and poor in 2 eyes (5%) , and predominantly eccentric in 2 eyes(5%) . Stable in 34 (85%) and relative unstable in 5 ( 12,5%) and unstable in 1 eye (2,5%). Mean central 4 degrees retinal sensitivity ± SD was 17,21 ± 2,06. Mean OCT foveal thickness ± SD was 246 ± 22,12. GCC thickness average was 86,25 ± 9,37. GCC thickness MS-ON average was 81,24 ± 9,74. Mean ONH Superior was 94,93 ± 10,83; mean ONH Inferior was 97,81 ± 12,29. Mean MD-HVF was -1,25 ± 2,32 e mean PSD-HVF was 2,43 ± 1,41.
Conclusions: :
FD-OCT and Microperimetry showed a reduction of GCC thickness and retinal sensitivity in almost 80% of eyes with multiple sclerosis, but more in eyes with optic neuritis history. Furthermore retinal nerve fiber layer loss is involved afterwards ganglion cell complex loss. FD-OCT and Microperimetry provide important informations in vivo on the role and timing of neuronal versus axonal loss in multiple sclerosis.
Keywords: ganglion cells • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)