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Mult Scler Relat Disord. 2018 May;22:141-147. doi: 10.1016/j.msard.2018.04.006. Epub 2018 Apr 9.

Frequent retinal ganglion cell damage after acute optic neuritis.

Author information

1
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: alexander.brandt@charite.de.
2
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Charitéplatz 1, 10117 Berlin, Germany.
3
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Charitéplatz 1, 10117 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neurology, Charitéplatz 1, 10117 Berlin, Germany; Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Experimental and Clinical Research Center, Lindenberger Weg 80, 13125 Berlin, Germany.
4
University of Calgary, Department of Clinical Neurosciences, 2500 University Dr. NW, Calgary, Alberta, Canada T2N 1N4; University of Calgary, Department of Surgery, Calgary, Alberta, Canada; Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1.

Abstract

BACKGROUND:

To identify the extent of ganglion cell damage after first-time optic neuritis (ON) using the inter-ocular difference between affected and fellow eyes, and whether this approach is able to detect more patients suffering from ganglion cell damage than using absolute values.

METHODS:

Thirty-four patients with first-time unilateral ON were followed for a median 413 days. Patients underwent optical coherence tomography testing to determine ganglion cell plus inner plexiform layer thickness (GCIP). Ganglion cell loss was quantified as GCIP difference between ON-affected and fellow eyes (inter-GCIP) and was compared against measurements from 93 healthy controls (HC). Visual function was assessed with high contrast visual acuity; and standard automated perimetry-derived measures of mean deviation and foveal threshold.

RESULTS:

At clinical presentation after median 19 days from symptom onset, 47.1% of patients showed early GCIP thinning in the ON-affected eye based on inter-GCIP. At the last visit acute ON was associated with 16.1 ± 10.0 µm GCIP thinning compared to fellow eyes (p = 3.669e-06). Based on inter-GCIP, 84.9% of ON patients sustained GCIP thinning in their affected eye at the last visit, whereas using absolute values only 71.0% of patients suffered from GCIP thinning (p = 0.002076). Only 32.3% of these patients had abnormal visual function. The best predictor of GCIP thinning as a measure of ON severity at the last visit was worse visual field mean deviation at clinical presentation.

CONCLUSION:

Inter-ocular GCIP identifies significantly more eyes suffering damage from ON than absolute GCIP, visual fields or visual acuity loss. Effective interventional options are needed to prevent ganglion cell loss.

KEYWORDS:

Multiple sclerosis; Optic neuritis; Optical coherence tomography; Vision

PMID:
29704802
DOI:
10.1016/j.msard.2018.04.006
[Indexed for MEDLINE]

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