Abstract
Purpose :
To investigate the longitudinal changes of the inner retina after the acute demyelinating optic neuritis (ON) had subsided and to identify the factors associated with the inner retina changes
Methods :
In this retrospective observational study, we reviewed the medical records of 77 patients with ON, including 23 patients with neuromyelitis optica spectrum disorder with AQP4-IgG (NMOSD group), 23 with MOG-antibody associated disease (MOGAD group), 18 with multiple sclerosis (MS group), and 13 with idiopathic optic neuritis (iON group). We measured the thickness of the peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell layer-inner plexiform layer (mGCIPL) using optical coherence tomography at baseline ON attack and follow-up in the absence of ON recurrence.
Results :
The estimated rate of pRNFL thinning in AQP4, MOG, MS, and iON groups was 0.66 (0.35 – 0.97) μm/year, 0.35 (0.04 – 0.66) μm/year, 0.53 (0.16 – 0.90) μm/year, and 0.25 (-0.18 – 0.68) μm/year, respectively, which means that there was no significant decrease of pRNFL thickness in the iON group in contrast to the other groups. Among the AQP4, MOG and MS groups, there was no significant difference in the rate of pRNFL thinning (p = 0.560). The rate of mGCIPL thinning in the AQP4 and MOG groups was 0.25 (0.04 – 0.46) μm/year and 0.38 (0.23 – 0.53) μm/year, respectively. Meanwhile, the rate of mGCIPL change in MS and iON groups was 0.04 (-0.12 – 0.19) μm/year and 0.00 (-0.17 – 0.16) μm/year, respectively, which indicates there was no significant thinning in mGCIPL thickness in the latter two groups. The rate of mGCIPL changes between AQP4 and MOG groups did not significantly differ (p = 0.295). Age older than 40 years was associated with the significant progression of mGCIPL thinning (p = 0.005).
Conclusions :
We found the progressive inner retinal thinning in attack-free period in AQP4-ON, MOG-ON, and MS-ON. Since subclinical neuroaxonal damages continue after the acute attack of ON subsides despite the suppression of new attacks of ON, long-term follow-up and neuroprotection will be important in patients with ON.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.