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Hollister Christian Swanson, Yasaira Rodriguez, Inna Glybina, Robert Tomsak; Longitudinal Study of Retinal Layer Changes using Optical Coherence Tomography in Multiple Sclerosis.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1859.
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© ARVO (1962-2015); The Authors (2016-present)
Multiple sclerosis is a neurodegenerative disease of the central nervous system which frequently presents with visual dysfunction. Literature suggests retinal changes can be observed through optical coherence tomography (OCT), specifically thinning within the ganglion cell complex (GCC) ( i.e. ganglion cell layer plus inner plexiform layer) and retinal nerve fiber layer (RNFL). In this study, we sought to further elucidate the prevalence and evolution of retinal layer changes in multiple sclerosis through observations in visual fields and OCT.
A retrospective chart review of 104 patients eighteen years or older was performed on patients evaluated at Kresge Eye Institute between January of 2010 and July 2018. Patients with ophthalmologic disorders affecting the retina were excluded. Data collected included clinical variables such as patient demographics (age, sex, gender), disease duration, visual related variables, disease activity, disease modifying therapies, and OCT measurements. Data were analyzed with SPSS (version 25).
The population was 76.0% female with a mean age of 44.4 years and mean disease duration of 8.4 years. The average length of follow-up was 2.1 years. In the population, the median best-corrected visual acuity was 20/25 with a history of 24.0% relative afferent pupillary defect, 11.5% nystagmus, and 21.1% diplopia. There was history of optic neuritis (ON) in 66.3% with only 4.1% of patients developing ON after initial presentation. There were 67.3% patients on immunomodulating therapy, 2.9% on chemotherapy, 3.9% on steroids, and 26.0% of patient had no known therapy. In patients without a history of ON, the average RNFL measured was 83.5 and the GCC was 71.1. For the group of patients with a history of ON demonstrated an average RNFL thickness of 80.8 and a GCC thickness of 65.2. The difference in means was statistically significant for average GCC (p = 0.009), however it was not significant for average RNFL (p = 0.334).
Trends in changes on OCT within the RNFL and GCC were consistent with current scientific literature. However, this study only demonstrated a statistically significant difference with GCC thickness in patients with ON compared to patients without ON.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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