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M. Takaoka, Y. Ikeda, J. Takahashi, K. Imai, T. Saida, S. Kinoshita; Retinal Nerve-Fiber Layer Thickness After Multiple Optic Neuritis Episodes in Neuromyelitis Optica and Multiple Sclerosis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):655.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate relationship between the retinal nerve-fiber layer thickness (RNFLT) and the number of clinically manifest optic neuritis (ON) episodes in relapsing neuromyelitis optica (NMO) and multiple sclerosis (MS) in Japanese.
This study involved 24 patients with NMO (2 males and 22 females; mean age: 51.7±15.2 years) who showed positive anti-aquaporin-4 antibodies and/or a centrally located long cord lesion extending >3 vertebral segments on spinal MRI, 33 patients with MS (13 males and 20 females; mean age: 38.9±10.2 years), and 35 age-matched healthy control individuals (11 males and 24 females; mean age: 37.6±10.0 years). The RNFLT of each subject was measured at 4 quadrants around the optic disc using 3D Optical Coherence Tomography (3D OCT-1000; Topcon, Tokyo, Japan). The average change per one ON episode of RNFLT in the 4 quadrants were calculated for each eye of each patient. The reduction rate with the number of ON episodes was then compared between NMO and MS. Linear regression analysis was used for statistical analysis.
RNFLT linearly decreased with the increasing number of ON episodes in both NMO and MS. The approximation formula slope of the RNFLT thinning with the number of ON episodes was significantly steeper in NMO than in MS (p<0.003). In eyes without previous ON episodes, RNFLT was significantly thinner than in healthy control eyes in either NMO (P<0.00001) or MS (P<0.002).
OCT revealed more severe retinal thickness reduction per single ON episode in NMO than in MS. In both disorders, RNFLT in the eyes without ON episodes were thinner than in controls, suggesting the presence of subclinical destructive processes. These results clearly demonstrate that ON of NMO is accompanied by severe axonal loss and OCT can play an important role in the evaluation of the disorder.
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