Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis
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- 25 May 2010
- journal article
- research article
- Published by Wiley in Annals of Neurology
- Vol. 67 (6), 749-760
- https://doi.org/10.1002/ana.22005
Abstract
Objective Cross‐sectional studies of optical coherence tomography (OCT) show that retinal nerve fiber layer (RNFL) thickness is reduced in multiple sclerosis (MS) and correlates with visual function. We determined how longitudinal changes in RNFL thickness relate to visual loss. We also examined patterns of RNFL thinning over time in MS eyes with and without a prior history of acute optic neuritis (ON). Methods Patients underwent OCT measurement of RNFL thickness at baseline and at 6‐month intervals during a mean follow‐up of 18 months at 3 centers. Low‐contrast letter acuity (2.5%, 1.25% contrast) and visual acuity (VA) were assessed. Results Among 299 patients (593 eyes) with ≥6 months follow‐up, eyes with visual loss showed greater RNFL thinning compared to eyes with stable vision (low‐contrast acuity, 2.5%: p < 0.001; VA: p = 0.005). RNFL thinning increased over time, with average losses of 2.9μm at 2 to 3 years and 6.1μm at 3 to 4.5 years (p < 0.001 vs 0.5–1‐year follow‐up interval). These patterns were observed for eyes with or without prior history of ON. Proportions of eyes with RNFL loss greater than test‐retest variability (≥6.6μm) increased from 11% at 0 to 1 year to 44% at 3 to 4.5 years (p < 0.001). Interpretation Progressive RNFL thinning occurs as a function of time in some patients with MS, even in the absence of ON, and is associated with clinically significant visual loss. These findings are consistent with subclinical axonal loss in the anterior visual pathway in MS, and support the use of OCT and low‐contrast acuity as methods to evaluate the effectiveness of putative neuroprotection protocols. ANN NEUROL 2010;67:749–760Keywords
This publication has 46 references indexed in Scilit:
- Brain atrophy in multiple sclerosis: what we know and would like to knowMultiple Sclerosis Journal, 2006
- The contribution of demyelination to axonal loss in multiple sclerosisBrain, 2006
- Contrast letter acuity as a visual component for the Multiple Sclerosis Functional CompositeNeurology, 2003
- Pattern reversal visual evoked potentials as a measure of visual pathway pathology in multiple sclerosisMultiple Sclerosis Journal, 2003
- How Sensitive to Clinical Change are ETDRS logMAR Visual Acuity Measurements?Investigative Ophthalmology & Visual Science, 2003
- Size-selective neuronal changes in the anterior optic pathways suggest a differential susceptibility to injury in multiple sclerosisBrain, 2001
- Relationship between brain atrophy and disability: an 8-year follow-up study of multiple sclerosis patientsMultiple Sclerosis Journal, 2000
- New low-contrast vision charts: reliability and test characteristics in patients with multiple sclerosisMultiple Sclerosis Journal, 2000
- Axonal Transection in the Lesions of Multiple SclerosisThe New England Journal of Medicine, 1998
- Recommendations from the national multiple sclerosis society clinical outcomes assessment task forceAnnals of Neurology, 1997