Effect of gestational age at birth, sex, and race on foveal structure in children.

PURPOSE: Premature birth, race, and sex are contributing risk factors for retinopathy of prematurity (ROP) and have long-term impact on children's retinal structure. Few studies investigate impact of race and sex on macular structure in children born preterm. This study compared foveal structure in preterm and full-term children. METHODS: Children aged 4-18 years were enrolled into three groups: (1) ROP-risk group (n = 81), born at < 32 weeks gestational age with and without history of ROP; (2) preterm group (n = 46), born at 32-36 weeks gestational age; and (3) control group (n = 68) with full-term birth. Using spectral-domain optical coherence tomography volume-scan images, foveal structure within 1-mm and 3-mm early treatment diabetic retinopathy study circular grid was measured and segmented. Total inner and outer retina thickness of the right eye was compared among the three groups. RESULTS: The mean total foveal thickness (in microns) was 287 ± 26 for the ROP-risk group, 276 ± 19 for the preterm group, and 263 ± 20 for the control group (F = 26, p < 0.001). Foveal thickness of the ROP-risk group was significantly higher than that of the preterm group and the control group (all p < 0.05). Foveal thickness was thinner in black children than in white children and thinner in females than in males (all p < 0.001). A similar disparity in race and sex was found in the thickness of the inner and outer layers. CONCLUSIONS: The fovea was significantly thicker in the ROP-risk group than the control group. Foveal thickness decreases with increased gestational age. Race and sex are significant factors in foveal structure in children.

Update on the diagnosis and treatment of neuromyelits optica spectrum disorders (NMOSD) - revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part I: Diagnosis and differential diagnosis.

The term 'neuromyelitis optica spectrum disorders' (NMOSD) is used as an umbrella term that refers to aquaporin-4 immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica (NMO) and its formes frustes and to a number of closely related clinical syndromes without AQP4-IgG. NMOSD were originally considered subvariants of multiple sclerosis (MS) but are now widely recognized as disorders in their own right that are distinct from MS with regard to immunopathogenesis, clinical presentation, optimum treatment, and prognosis. In part 1 of this two-part article series, which ties in with our 2014 recommendations, the neuromyelitis optica study group (NEMOS) gives updated recommendations on the diagnosis and differential diagnosis of NMOSD. A key focus is on differentiating NMOSD from MS and from myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis (MOG-EM; also termed MOG antibody-associated disease, MOGAD), which shares significant similarity with NMOSD with regard to clinical and, partly, radiological presentation, but is a pathogenetically distinct disease. In part 2, we provide updated recommendations on the treatment of NMOSD, covering all newly approved drugs as well as established treatment options.

Resolution of Optic Disc Pit Maculopathy Following Posterior Vitreous Detachment.

Purpose: This work presents a case of significant improvement of optic pit disc maculopathy following an acute posterior vitreous detachment (PVD) and discusses the possible mechanisms of this phenomenon. Methods: A case report and review of the literature are presented. Results: A 56-year-old man presenting with progressive visual decline in his left eye was found to have an optic disc pit with optical coherence tomography (OCT) evidence of severe intraretinal edema and maculoschisis. His visual acuity and macular anatomy on OCT improved dramatically in the months following a PVD. Conclusions: This report presents an interesting case of spontaneous improvement of optic disc pit-related maculopathy following PVD. We discuss the cause of the retinal fluid accumulation in optic disc pit maculopathy and consider that the OCT findings in our case lend credence to the theory that this fluid originates from the vitreous humor.

Retinal Nerve Fiber Layer Thickness Correlates with Serum and Cerebrospinal Fluid Neurofilament Levels and is Associated with Current Disability in Multiple Sclerosis.

INTRODUCTION: The main purpose of the present study is to confirm Peripapillary Retinal Nerve Fiber Layer (pRNFL) thickness is a biomarker of axonal degeneration in patients with Multiple Sclerosis (MS) and to evaluate its relationship with Neurofilament heavy chain (NfH) and Nitrotyrosine (NT). METHOD: We quantified serum (s) and/or cerebrospinal fluid (CSF) NfH and NT levels in 30 relapsing-remitting MS patients (RRMS), 16 secondary progressive MS (SPMS) patients and in 29 control subjects matched for age and gender. Optical coherence tomography (OCT) measurements of pRNFL were performed in all subjects. Clinical outcomes were tested by Multiple Sclerosis Functional Composite (MSFC) and Expanded Disability Status Scale (EDSS). RESULTS: RRMS patients exhibited significantly higher NfH/NT levels (99 pg/mL, 107.52 nM respectively) than controls (74 pg/mL, 48.72 nM) in CSF (p<0.0001), but not in sera. SPMS patients had significantly higher s NfH/NT values (111.25 pg/mL, 1251.77 nM respectively) and lower mean pRNFL thickness (79 µm) than patients with RRMS (98.50 µm) and controls (108 µm) (p<0.0001). pRNFL thickness was significantly correlated with all clinical disability measurements (EDSS, Trail Making test, 9-Hole Peg Test, and PASAT) in both RRMS and SPMS (p<0.001, p=0.02, p=0.03, p=0.02 respectively). A positive correlation was also found between serum and/or CSF NfH levels and EDSS scores in RRMS and SPMS (p<0.001, p=0.02 respectively). The pRNFL thickness was also correlated significantly with serum and/or CSF NfH levels but not with s/CSF NT levels in both clinical forms of MS (p<0.01, p<0.001 respectively). CONCLUSION: The current study demonstrated that both pRNFL and s/CSF NfH are reliable and quantitative biomarkers that correlate with current disease course and cross-sectional measure of disability in patients with MS.

Correlation of neutrophyle/lymphocyte ratio and pulmonary parameters with optic coherence tomography findings in stable chronic obstructive pulmonary disease.

INTRODUCTION: To examine the correlation of pulmonary functions and neutrophyle/lymphocyte ratio (NLR) with optic coherence tomography findings in stable chronic obstructive pulmonary disease (COPD). METHODS: Fifty-five COPD (110 eyes) and 48 control cases (96 eyes) were enrolled. COPD patients were grouped as Group 1 (mild-moderate) and Group 2 (severe) according to GOLD classification. Subfoveal choroidal thickness (SFCT), ganglion cell-inner plexiform layer (GCIP) and retinal nerve fiber layer (RNFL) analysis by SD-OCT were performed in follow up. NLR was calculated by blood cell count. RESULTS: Inferior RNFL and average GCIP of COPD were lower than control during the initial and sixth month examination (P = .002, P < .001, respectively). Average RNFL and SFCT were lower in COPD patients in sixth month examination (P = .020, P = .015, respectively). Average, temporal, inferior, nasal RNFL and SFCT in sixth month examination were significantly lower in severe COPD (P < .05 for all), but average GCIP were similar (P = .015). Disease duration, Modified Medical Research Council (mMRC) and attacks/year showed significant negative correlations, whereas forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) showed significant positive correlations with OCT values. NLR was significantly higher in COPD cases compared to control (P < .001) and had a negative correlation with GCIP values. CONCLUSION: Chronic obstructive pulmonary disease severity is shown to have a negative effect on OCT measurements. SD-OCT can reflect severity of inflammation, and suggested to be used in follow up of COPD cases. NLR may have a role to predict the ganglion cell damage in COPD patients.

Optical coherence tomography versus visual evoked potentials in detecting subclinical visual impairment in multiple sclerosis.

RATIONALE: Visual impairment is one of the most common clinical manifestations of multiple sclerosis (MS). Some multiple sclerosis patients complain of poor vision although the Snellen visual acuity is 20/20. This study reveals that sensitive measurements like visual evoked potential (VEP) and optical coherence tomography (OCT) can evidence subclinical disturbances of visual pathway. These methods examine the relation between the visual function (VEP) and retinal nerve fiber layer (RNFL) thickness, as a structural biomarker for axonal loss in patients with multiple sclerosis (MS). The findings in this study indicate the utility of combining structural and functional testing in clinical research on patients with MS. PURPOSE: To detect visual impairment in a population of visually asymptomatic patients affected by clinically definite multiple sclerosis (MS) and to compare the utility of optical coherence tomography (OCT) versus visual evoked potentials (VEP). MATERIAL AND METHODS: Fourteen patients (28 eyes) affected by clinically definite MS, without a history of optic neuritis and asymptomatic for visual disturbances, were initially fully examined (visual acuity, ocular fundus, biomicroscopy) from an ophthalmic point of view and then measured by OCT (RNFL thickness) and VEP. Patients with a history of glaucoma or other retinal or optic nerve disease were excluded. RESULTS: Of fourteen patients (28 eyes), VEP was abnormal in 11 cases (78,57%) and OCT (RNFL thickness) was abnormal in 5 cases (35,71%), while 3 patients had no abnormalities on neither tests. CONCLUSIONS: Optical coherence tomography (OCT) is less sensitive than visual evoked potentials (VEPs) in detecting visual subclinical impairment in patients with multiple sclerosis (MS). VEP remains the preferred test for the detection of clinical and subclinical optic neuritis. OCT may provide complementary information to VEP in cases with clinical definite MS and represent a valuable research instrument for the study of optic nerve disease in populations. The findings in this study reveal the utility of combining structural and functional testing in clinical research on patients with MS.