Using retinal architecture to help characterize multiple sclerosis patients

• Published in: Canadian journal of ophthalmology 2010-10, Vol.45 (5), p.520-526
• Main Authors: Costello, Fiona, MD, FRCPC, Hodge, William, MD, PhD, FRCSC, Pan, Y. Irene, MSc, Eggenberger, Eric, DO, MS, Freedman, Mark S., MD, FRCPC
• Format: Article
• Language: English
• Subjects: Adult; Cross-Sectional Studies; Female; Humans; Internal Medicine; Male; multiple sclerosis; Multiple Sclerosis - diagnosis; Nerve Fibers - pathology; Ophthalmology; optic neuritis; Optic Neuritis - diagnosis; optical coherence tomography; Retinal Ganglion Cells - pathology; Tomography, Optical Coherence; Visual Acuity - physiology; Visual Fields - physiology
• ISSN: 0008-4182; 1715-3360
• DOI: 10.3129/i10-063

Abstract Objective: We compared retinal nerve fibre layer (RNFL) thickness and visual function in a heterogeneous multiple sclerosis (MS) cohort to determine whether optical coherence tomography (OCT) may complement the existing methods used to characterize MS patients. Design: Cross-sectional cohort study. Participants: One hundred and ninety-three patients with optic neuritis (ON) as a clinically isolated syndrome (CIS) ( n = 63), relapsing-remitting MS (RRMS) ( n = 108), secondary progressive MS (SPMS) ( n = 13), and primary progressive MS (PPMS) ( n = 9). Methods: All patients underwent standardized ophthalmic, neurological, and OCT testing at a single academic institution. Results: RNFL values were reduced in PPMS (94.3 μm), RRMS (99.6 μm), and SPMS eyes (84.7 μm) relative to CIS eyes (105.7 μm) ( p < 0.0001). RNFL values were lower in eyes with recurrent ON (64.2 μm) relative to eyes affected by a single ON event (86.3 μm) ( p < 0.0001). The strongest correlation between RNFL thickness and neurological disability occurred in RRMS patients ( r = −0.51, p < 0.0001). RNFL thickness correlated with visual field sensitivity for CIS ( r = 0.23, p < 0.01) and RRMS ( r = 0.22, p < 0.01) patients. Simple linear regression showed that every 10 μm decrease in RNFL correlated with a 5.8 decibel decrease in visual field sensitivity (adjusted R2 = 0.35, p < 0.0001) for RNFL values less than 75 μm. Conclusions: There were robust correlations between RNFL thickness and visual function, particularly in ON eyes. OCT may complement the existing tools used to characterize MS patients, but further studies are needed.