Abstract
Purpose :
Recovery of high contrast visual acuity (HCVA) and 30-2 perimetry are typically excellent, while reduced contrast sensitivity persists in 56% of eyes after an episode of optic neuritis. Cross sectional studies of MS patients show low contrast visual acuity (LCVA) correlates modestly with RNFL thickness and macula ganglion cell +IPL layer (GCL) thickness. Given the profound vision deficits at onset, and GCL thinning at outcome, we hypothesized 10-2 perimetry and LCVA deficits would be frequent following an episode of optic neuritis.
Methods :
We prospectively studied 32 eyes of 32 patients (9 men, 23 women, age 34 years ± 10) with first time acute optic neuritis and measured LCVA 2.5% (# letters seen), GCL thickness and loss, and 10-2 mean deviation (MD) at 6 months
Results :
GCL thickness was normal (82.1µ ± 6.7, 82.81 µ ± 5.1 fellow eyes), LCVA was 1.6 ± 7.4 (28.1 fellow eye), HCVA was 28.8 ± 23 at presentation. At 6 months, deficits were less but persisted for LCVA mean 12.6 ± 15.8 (34.1 ± 10.6 in fellow eye, p=0.001) in all but 4 eyes, and for MD (-4.26 dB ± 3.99, -1.38 dB ± 1.39 fellow eye, p=0.01). Average GCL was thinned (69.6 µ ± 9.6, 82.7 µ ± 4.7 fellow eyes, p=0.001), with thinning in all but 3 eyes. GCL thickness correlated with MD (0.43, p = 0.015) but not with LCVA at 6 months. Mean GCL loss (12.4 µ ± 8.4) correlated strongly with MD (-0.60, p=0.001) and moderately with LCVA (-0.46, p=0.008).
Conclusions :
GCL thickness is the best structural and LCVA and 10-2 MD are sensitive functional measures for determining residual deficits due to optic neuritis. The 10-2 MD correlates best with the outcome GCL thickness and loss.
This is a 2020 ARVO Annual Meeting abstract.