Ganglion cell analysis in acute optic neuritis.

BACKGROUND: Optic neuritis has a diagnostic and prognostic significance in predicting the development of multiple sclerosis. Optical coherence tomography is being increasingly used to detect and monitor axonal damage in MS by measuring the retinal nerve fiber layer (RNFL). However, RNFL can be affected by edema and inflammation and obscure early axonal damage. OBJECTIVE: To study the pattern of change in the ganglion cell and inner plexiform layer compared to retinal nerve fibber layer in acute optic neuritis using spectral domain OCT. METHODS: Ten patients with acute optic neuritis were followed prospectively for 6 months with spectral domain optical coherence tomography. A group of 40 of eyes of 20 healthy controls was used for baseline comparison. RESULTS: The ganglion cell and inner plexiform layer (GCIPL) was significantly lower (thinner) at onset in patients' affected (p=0.009) eyes. Both RNFL and GCIPL were significantly lower in affected eyes at 6 months (p=0.012 and p=0.007) respectively compared to baseline. CONCLUSION: The GCIPL is probably more sensitive index of axonal loss than the RNFL in acute optic neuritis and could be a better index to detect neurodegeneration in multiple sclerosis. This can helpful in estimating early axonal loss and can potentially be used in therapeutic trials of neuroprotective drugs.

Hybrid (COPP/ABV) therapy in childhood Hodgkin's disease: a study of 53 cases during 1989-1993 at the Cancer Institute, Madras.

The optimal therapy for children with Hodgkin's disease is controversial. Between 1989 and 1993, 53 children under 14 years of age with Hodgkin's disease were treated with COPP/ABV (cyclophosphamide, vincristine, procarbazine, prednisolone/adriamycin, bleomycin, vinblastine) hybrid chemotherapy. The results were analyzed with the Kaplan-Meier product limit method for survival and the Logrank test for predicting statistical significance. Ten patients (18.87%) had early-stage disease (I to IIA) and 43 (81.13%) had advanced disease. Lymphocyte-predominant histology was seen in 20 (37.5%) patients, nodular sclerosis in 8 (15%), mixed cellularity in 21 (39.6%), and lymphocyte depletion in 4 (7.56%). The male:female ratio was 3.82:1. Complete responses were seen in 51 (96.22%) patients, with 47 (92.15%) of them in sustained first remission. The event-free survival rate is 90.3% to date. COPP/ABV hybrid chemotherapy is an effective primary therapy for all stages of Hodgkin's disease in children.