Subclinical neurodegeneration in multiple sclerosis and neuromyelitis optica spectrum disorder revealed by optical coherence tomography.
Mult Scler
; 26(10): 1197-1206, 2020 09.
Article
in En
| MEDLINE
| ID: mdl-31392924
ABSTRACT
BACKGROUND:
Neuroretinal atrophy is associated with whole-brain atrophy and disease activity in multiple sclerosis (MS). Recent findings support that subclinical visual pathway involvement might also occur in neuromyelitis optica spectrum disorders (NMOSDs).OBJECTIVE:
The objective of this study is to assess retinal thinning in MS and NMOSD and its association with disease activity.METHODS:
In total, 27 NMOSD and 54 propensity-score-matched MS patients underwent optical coherence tomography, visual acuity, and visual-evoked potentials at 2.4 years apart, in addition to routine clinical and magnetic resonance imaging (MRI) assessment. We excluded eyes with acute optic neuritis.RESULTS:
In NMOSD, we detected peripapillary retinal nerve fiber layer (pRNFL) thinning in patients with disease activity during follow-up (-0.494 µm/year), but not in stable patients (-0.012 µm/year). Macular ganglion cell-inner plexiform layer (GCIPL) thinning occurred instead in all patients (-0.279 µm/year). Relapsing-remitting multiple sclerosis (RRMS) meeting NEDA-3 criteria had no pRNFL or GCIPL thinning during follow-up. Active-disease RRMS and progressive MS, both active and stable, displayed pRNFL (-0.724, -0.586, -0.556 µm/year, respectively) and GCIPL loss.CONCLUSION:
In MS, neuroretinal atrophy was associated with disease activity but occurred in progressive MS even when achieving NEDA-3 criteria. In NMOSD, pRNFL thinning was associated with non-ocular relapses due to a spreading of inflammatory activity. GCIPL thinning was found in all patients, supporting a primary retinal pathology targeting AQP4-rich structures.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Optic Neuritis
/
Neuromyelitis Optica
/
Multiple Sclerosis
Limits:
Humans
Language:
En
Journal:
Mult Scler
Journal subject:
NEUROLOGIA
Year:
2020
Document type:
Article
Affiliation country: