Objective: The objective of this research was to study the effect of optic neuritis (ON) on axonal damage in multiple sclerosis (MS) patients. Specifically, we compared changes over 2 years in the retinal nerve fibre layer (RNFL) between affected and contralateral eyes in MS patients with a prior history of ON.
Methods: Thirty-four patients with one unilateral definitive episode of ON were included and underwent a complete ophthalmic examination, optical coherence tomography (OCT), scanning laser polarimetry, visual evoked potentials (VEP) and pattern electroretinogram (pERG). All patients were re-evaluated at 12 and 24 months. Parameters were compared between ON-affected and contralateral eyes in an initial exploration and over the course of the follow-up. Correlations between parameter changes were analysed.
Results: RNFL thickness and functional parameters showed more affection in ON eyes (p ≤ 0.05), but changes in measurements during the study were similar between both groups of eyes.
Conclusions: Progressive axonal loss can be detected in the optic nerve, but ON is not a risk factor for increased chronic damage in MS patients without ophthalmic relapses. Loss of the RNFL is caused by progressive degeneration associated with the disease.
TripSASchlottmannPGJonesSJKallisCAltmannDRGarway-HeathDF. Scanning laser polarimetry quantification of retinal nerve fiber layer thinning following optic neuritis. J Neuroophthalmol2010; 30: 235–242.
2.
SergottRCFrohmanEGlanzmanRAl-SabbaghA. The role of optical coherence tomography in multiple sclerosis: expert panel consensus. J Neurol Sci2007; 263: 3–14.
3.
SycSBWarnerCVHiremathGSFarrellSKRatchfordJNCongerA. Reproducibility of high-resolution optical coherence tomography in multiple sclerosis. Mult Scler2010; 16: 829–839.
4.
KhanifarAAParlitsisGJEhrlichJRAakerGDD'AmicoDJGauthierSA. Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography. Clin Ophthalmol2010; 4: 1007–1013.
5.
AlmarceguiCDolzIPueyoVGarciaEFernandezFJMartinJ. Correlation between functional and structural assessments of the optic nerve and retina in multiple sclerosis patients. Neurophysiol Clin2010; 40: 129–135.
6.
PetzoldAde BoerJFSchipplingSVermerschPKardonRGreenA. Optical coherence tomography in multiple sclerosis: a systematic review and meta-analysis. Lancet Neurol2010; 9: 921–932.
7.
Gordon-LipkinEChodkowskiBReichDSSmithSAPulickenMBalcerLJ. Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology2007; 69: 1603–1609.
8.
Garcia-MartinEPueyoVMartinJAlmarceguiCAraJRDolzI. Progressive changes in the retinal nerve fiber layer in patients with multiple sclerosis. Eur J Ophthalmol2009; 20: 167–173.
9.
SepulcreJMurie-FernandezMSalinas-AlamanAGarcia-LayanaABejaranoBVillosladaP. Diagnostic accuracy of retinal abnormalities in predicting disease activity in MS. Neurology2007; 68: 1488–1494.
10.
Kallenbach K, Sander B, Tsakiri A, Wanscher B, Fuglø D, Larsen M, et al. Neither retinal nor brain atrophy can be shown in patients with isolated unilateral optic neuritis at the time of presentation. Mult Scler. 2010; 17 (1): 89–95.
11.
FrohmanEMDwyerMGFrohmanTCoxJLSalterAGreenbergBM. Relationship of optic nerve and brain conventional and non-conventional MRI measures and retinal nerve fiber layer thickness, as assessed by OCT and GDx: a pilot study. J Neurol Sci2009; 282: 96–105.
12.
LamirelCNewmanNJBiousseV. Optical coherence tomography (OCT) in optic neuritis and multiple sclerosis. Rev Neurol (Paris)2010; 166: 978–986.
13.
TalmanLSBiskerERSackelDJLongDAGalettaKMRatchfordJN. Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. Ann Neurol2010; 67: 749–760.
14.
CostelloFCouplandSHodgeWLorelloGRKorolukJPanYI. Quantifying axonal loss after optic neuritis with optical coherence tomography. Ann Neurol2006; 59: 963–969.
15.
DellaMGBacchettiSZeppieriMBrusiniPCutuliDGigliGL. Nerve fibre layer analysis with GDx with a variable corneal compensator in patients with multiple sclerosis. Ophthalmologica2007; 221: 186–189.
16.
HolderGEBrigellMGHawlinaMMeigenTVaeganMBachM. ISCEV standard for clinical pattern electroretinography. Doc Ophthalmol2007; 114: 111–116.
17.
ImitolaJChitnisTKhourySJ. Insights into the molecular pathogenesis of progression in multiple sclerosis: potential implications for future therapies. Arch Neurol2006; 63: 25–33.
18.
SmithKJKapoorRHallSMDaviesM. Electrically active axons degenerate when exposed to nitric oxide. Ann Neurol2001; 49: 470–476.
19.
Gordon-LipkinEChodkowskiBReichDSSmithSAPulickenMBalcerLJ. Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology2007; 69: 1603–1609.
20.
Danesh-MeyerHVBirchHKuJYCarrollSGambleG. Reduction of optic nerve fibers in patients with Alzheimer disease identified by laser imaging. Neurology2006; 67: 1852–1854.
21.
ZaveriMSCongerASalterAFrohmanTCGalettaSLMarkowitzCE. Retinal imaging by laser polarimetry and optical coherence tomography evidence of axonal degeneration in multiple sclerosis. Arch Neurol2008; 65: 924–928.
22.
GrazioliEZivadinovRWeinstock-GuttmanBLincoffNBaierMWongJR. Retinal nerve fiber layer thickness is associated with brain MRI outcomes in multiple sclerosis. J Neurol Sci2008; 268: 12–17.
23.
Garcia-Martin E, Pinilla I, Idoipe M, Fuertes I and Pueyo V. Intra and interoperator reproducibility of retinal nerve fiber and macular thickness measurements using Cirrus Fourier-domain OCT. Acta Ophthalmol. 2010 Nov 25. doi: 10.1111/j.1755-3768.2010.02045.x. [Epub ahead of print].
24.
Klistorner A, Arvind H, Garrick R, Graham S, Paine M and Yiannikas C. Correlation of optical coherence tomography and multifocal visual-evoked potential after optic neuritis. Invest Ophthalmol Vis Sci 2009 (in press).
25.
NovalSContrerasIRebolledaGMunoz-NegreteFJ. Optical coherence tomography versus automated perimetry for follow-up of optic neuritis. Acta Ophthalmol Scand2006; 84: 790–794.
26.
NaismithRTTutlamNTXuJShepherdJBKlawiterECSongSK. Optical coherence tomography is less sensitive than visual evoked potentials in optic neuritis. Neurology2009; 73: 46–52.
