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. 2017 Dec 13:8:675.
doi: 10.3389/fneur.2017.00675. eCollection 2017.

The Temporal Retinal Nerve Fiber Layer Thickness Is the Most Important Optical Coherence Tomography Estimate in Multiple Sclerosis

Ulrika Birkeldh  1 , Ali Manouchehrinia  2 , Max Albert Hietala  2 , Jan Hillert  2 , Tomas Olsson  2 , Fredrik Piehl  2 , Ingrid Skelton Kockum  2 , Lou Brundin  2 , Ori Zahavi  1 , Marika Wahlberg-Ramsay  1 , Rune Brautaset  1 , Maria Nilsson  1
Affiliations

The Temporal Retinal Nerve Fiber Layer Thickness Is the Most Important Optical Coherence Tomography Estimate in Multiple Sclerosis

Ulrika Birkeldh et al. Front Neurol. .

Abstract

Background: Reduced peripapillary retinal nerve fiber layer (pRNFL) and combined ganglion cell and inner plexiform layer (GCIP) thicknesses as measured by optical coherence tomography (OCT) have been observed in multiple sclerosis (MS) patients. The purpose was to determine the most associative OCT measure to level of cognitive and physical disability in MS.

Methods: Data were collected from 546 MS patients and 175 healthy controls (HCs). We compared the average pRNFL, temporal pRNFL (T-pRNFL), overall inner ganglion cell/inner plexiform layer (GCIP), and the overall ganglion cell complex (GCC) including macular RNFL and GCIP thicknesses measurements in differentiating MS subtypes from HCs. The association between OCT measures, Expanded Disability Status Scale (EDSS), and Symbol Digit Modalities Test (SDMT) were assessed using generalized estimating equations models.

Results: Both peripapillary and macular OCT measurements could differentiate all MS subtypes from HCs. The SDMT score was significantly associated with reduced thickness of all OCT measures, mostly in average pRNFL (0.14 µm, P = 0.001) and T-pRNFL (0.17 µm, P < 0.001). The EDSS score was significantly associated with reduced inner retinal layer thickness. The largest reduction was seen in T-pRNFL (-1.52 μm, P < 0.001) and inner GCC (-1.78 μm, P < 0.001).

Conclusion: The T-pRNFL is highly sensitive and associated with level of both cognitive and physical disability.

Keywords: cognitive impairment; ganglion cell–inner plexiform layer; multiple sclerosis; optical coherence tomography; physical disability; retinal nerve fiber layer.

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Figures

Figure 1
Figure 1
The ganglion cell thickness map as a complex including macular retinal nerve fiber layer, macular ganglion cell layer, and macular inner plexiform layer (ganglion cell complex) (illustration inspired from Ng et al., 2015).
Figure 2
Figure 2
Progression of cognitive impairment [Symbol Digit Modalities Test (SDMT) score] according to the baseline optical coherence tomography (OCT) measures. “Normal” OCT measure falls within one SD of the respective measure in healthy controls (HCs). “Reduced” measures are two or more SDs lower than the respective measure in HCs.
Figure 3
Figure 3
Progression of Expanded Disability Status Scale (EDSS) score according to the baseline optical coherence tomography (OCT) measures. “Normal” OCT measure falls within one SD of the respective measure in healthy controls (HCs). “Reduced” measures are two or more SDs lower than the respective measure in HCs.
See this image and copyright information in PMC

References

    1. Pulicken M, Gordon-Lipkin E, Balcer LJ, Frohman E, Cutter G, Calabresi PA. Optical coherence tomography and disease subtype in multiple sclerosis. Neurology (2007) 69(22):2085–92.10.1212/01.wnl.0000294876.49861.dc - DOI - PubMed
    1. Petzold A, de Boer JF, Schippling S, Vermersch P, Kardon R, Green A, et al. Optical coherence tomography in multiple sclerosis: a systematic review and meta-analysis. Lancet Neurol (2010) 9(9):921–32.10.1016/s1474-4422(10)70168-x - DOI - PubMed
    1. Fjeldstad C, Bemben M, Pardo G. Reduced retinal nerve fiber layer and macular thickness in patients with multiple sclerosis with no history of optic neuritis identified by the use of spectral domain high-definition optical coherence tomography. J Clin Neurosci (2011) 18(11):1469–72.10.1016/j.jocn.2011.04.008 - DOI - PubMed
    1. Gelfand JM, Goodin DS, Boscardin WJ, Nolan R, Cuneo A, Green AJ. Retinal axonal loss begins early in the course of multiple sclerosis and is similar between progressive phenotypes. PLoS One (2012) 7(5):e36847.10.1371/journal.pone.0036847 - DOI - PMC - PubMed
    1. Oberwahrenbrock T, Schippling S, Ringelstein M, Kaufhold F, Zimmermann H, Keser N, et al. Retinal damage in multiple sclerosis disease subtypes measured by high-resolution optical coherence tomography. Mult Scler Int (2012) 2012:530305.10.1155/2012/530305 - DOI - PMC - PubMed

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