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Abstract
Objective: To investigate the potential links between thinning of retinal ganglion cell axons in eyes of patients with multiple sclerosis (MS) without past optic neuritis (ON) and MS-related inflammatory damage of the posterior visual pathway.
Methods: Temporal retinal nerve fiber layer (tRNFL) thickness was analyzed in eyes with no history of ON (NON) from 53 patients with relapsing-remitting MS. Fifty normal age- and sex-matched controls were examined with optical coherence tomography. Low-contrast visual acuity charts were used for functional assessment of vision. The optic tract (OT) and optic radiation (OR) were identified using probabilistic tractography, and volume of T2 fluid-attenuated inversion recovery lesions and diffusion tensor imaging (DTI) indices were measured within both structures. Cross-sectional diameter of the OT was also calculated.
Results: tRNFL thickness was significantly reduced in NON eyes and was associated with reduced low-contrast visual acuity. Lesions within the OR were detected in the majority of patients. There was a significant correlation between thinning of the tRNFL and OR lesion volume (adjusted for non-OR lesion volume, age, sex, and disease duration). tRNFL thickness also correlated with OR DTI indices. No OT lesions were identified in any of the patients and no relationship between retinal nerve fiber layer loss and potential markers of OT lesions was found.
Conclusion: The results demonstrate a strong tract-specific association between loss of tRNFL fibers and MS-related inflammation within OR.
GLOSSARY
- AD=
- axial diffusivity;
- ANOVA=
- analysis of variance;
- DTI=
- diffusion tensor imaging;
- FA=
- fractional anisotropy;
- FLAIR=
- fluid-attenuated inversion recovery;
- GCL=
- ganglion cell layer;
- gRNFL=
- global retinal nerve fiber layer;
- INL=
- inner nuclear layer;
- IPL=
- inner plexiform layer;
- LCLA=
- low-contrast letter acuity;
- MD=
- mean diffusivity;
- mfVEP=
- multifocal visual evoked potentials;
- MS=
- multiple sclerosis;
- NON=
- no history of optic neuritis;
- OCT=
- optical coherence tomography;
- ON=
- optic neuritis;
- ONL=
- outer nuclear layer;
- OPL=
- outer plexiform layer;
- OR=
- optic radiations;
- OT=
- optic tracts;
- PIS=
- photoreceptor inner segment;
- RD=
- radial diffusivity;
- RGC=
- retinal ganglion cells;
- RNFL=
- retinal nerve fiber layer;
- RRMS=
- relapsing-remitting multiple sclerosis;
- tRNFL=
- temporal retinal nerve fiber layer;
- VA=
- visual acuity
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 2152
Supplemental data at Neurology.org
- Received October 23, 2013.
- Accepted in final form February 3, 2014.
- © 2014 American Academy of Neurology
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