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Thiago Gomes Filgueiras, Maria Kiyoko Oyamada, Rony C Preti, Samira Apostolos Pereira, Dagoberto Calegaro, Mario R Monteiro; Evaluation of Retinal Layers in Patients with Multiple Sclerosis or Neuromyelitis Optica Spectrum Disease Using ERG Oscillatory Potentials, mfERG and OCT. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5646. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine oscillatory potentials (OP) on full-field ERG, multifocal (mf) ERG and retinal layer thickness measurements using spectral domain-optical coherence tomography (sd-OCT) in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO) and NMO spectrum (NMOsp) disease.
167 eyes of 89 subjects divided in groups: MS with (MSON) and without (MSnon-ON) previous ON, NMO, and NMOsp without ON (NMO non-ON) (with extensive transverse myelitis) and controls were evaluated. Subjects were submitted to ERG OP determination and mf-ERG amplitude measurements using the RETI System®. For mfERG a 61-hexagon stimulus pattern was presented on a pseudo randomic form on a 21-inch black-and-white flat monitor. Mf-ERG P1 and N2 responses, were grouped in 2 concentric rings after excluding the outermost ring responses. Subjects underwent macular Spectralis-OCT scanning. Full-thickness macular and 6 segmented layers: retinal nerve fiber layer (RNFL), Ganglion Cells Layer (GCL), Inner Plexiform Layer (IPL), Inner Nuclear Layer, Outer Plexiform Layer and Outer Nuclear Layer were determined. Measurements were compared using generalized estimating equation models.
Average macular GCL and IPL were significantly thinner than controls for all patient groups (p<0.05). Compared to controls full thickness macular measurements was significantly reduced in MSON and NMO eyes while macular RNFL was reduced in all but the NMOsp non-ON groups. No significant difference was observed in the remaining layers. Mean±SD average OP was increased in NMO eyes compared to controls (18.5±5.5 and 15.1±8.7, respectively, p<0.05) and did not differ in the other groups. Significant higher average P1 and N2 amplitude values were observed for total, central and peripheral ring mfERG determinations in both MS groups compared to controls (p<0.05). No significant difference was observed for NMO and NMOsp non-ON groups compared to controls except for increased total (both groups) and peripheral (NMO group) P1 amplitude response.
While MS and NMO leads to predominant abnormalities in inner retinal layers on sd-OCT, ERG findings indicate dysfunction also in outer retinal function. Combined to sd-OCT, ERG and mfERG could be useful in the differentiation of MS and NMO but further studies are necessary to better understand such findings.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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