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Review
. 2017 Dec 22;9(1):21-33.
doi: 10.1007/s13167-017-0123-5. eCollection 2018 Mar.

Optical coherence tomography in neuromyelitis optica spectrum disorders: potential advantages for individualized monitoring of progression and therapy

Frederike C Oertel  1 , Hanna Zimmermann  1 , Friedemann Paul  1   2   3 , Alexander U Brandt  1
Affiliations
Review

Optical coherence tomography in neuromyelitis optica spectrum disorders: potential advantages for individualized monitoring of progression and therapy

Frederike C Oertel et al. EPMA J. .

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) are mostly relapsing inflammatory disorders of the central nervous system (CNS). Optic neuritis (ON) is the first NMOSD-related clinical event in 55% of the patients, which causes damage to the optic nerve and leads to visual impairment. Retinal optical coherence tomography (OCT) has emerged as a promising method for diagnosis of NMOSD and potential individual monitoring of disease course and severity. OCT not only detects damage to the afferent visual system caused by ON but potentially also NMOSD-specific intraretinal pathology, i.e. astrocytopathy. This article summarizes retinal involvement in NMOSD and reviews OCT methods that could be used now and in the future, for differential diagnosis, for monitoring of disease course, and in clinical trials.

Keywords: Diagnosis, differential; Disease progression; Neuromyelitis optica; Optic neuritis; Retina; Tomography, optical coherence; Vision disorders.

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Conflict of interest statement

Compliance with ethical standardsF. C. Oertel reports no conflicts of interest. H. Zimmermann received speaker honorary from TEVA and Bayer Healthcare, independent from this work. A. U. Brandt received consulting fees unrelated to this study for research from Novartis, Biogen, Motognosis, Teva, and Bayer. FP received research support from the German Ministry for Education and Research (BMBF/KKNMS; Competence Network Multiple Sclerosis), the Deutsche Forschungsgemeinschaft (DFG) (grant exc. 257), and from the Guthy Jackson Charitable Foundation and National Multiple Sclerosis Society as well as research grants and speaker honoraria from Bayer, Teva, Genzyme, Merck, Novartis, MedImmune and is member of the steering committee of the OCTIMS study (Novartis).

Figures

Fig. 1
Fig. 1
Anatomy of the retina (a) with corresponding layers measured by OCT as suggested by Staurenghi et al. [172] and Cruz-Herranz et al. [97] (b). Parts of the figure are provided by courtesy of www.neurodial.de [173]. OCT optical coherence tomography, RNFL retinal nerve fiber layer, GCIP combined ganglion cell and inner plexiform layer, INL inner nuclear layer, OPL outer plexiform layer, ONL outer nuclear layer, ELM & MZ external limiting membrane and myoid zone, OSP outer segments of photoreceptors (ellipsoid zone), RPE/B retinal pigment epithelium and Bruch’s complex
Fig. 2
Fig. 2
Neuro-axonal damage after ON in NMOSD for A an eye not affected by ON in an NMOSD patient compared to B an eye after one single ON in an NMOSD patient and C an eye after multiple ONs of an NMOSD patient. (1) TMV around the fovea with (2) corresponding macular volume of represented segments. (3) Peripapillary ring scan around the optic nerve head with marked retinal nerve fiber layer for pRNFL measurements. (4) Color-coded image of the pRNFL thicknesses compared to a healthy cohort from the device’s normative database: green: not reduced compared to a healthy cohort (> fifth percentile), yellow: borderline thinned compared to a healthy cohort (< fifth percentile), red: severely reduced compared to a healthy cohort (< first percentile). ON optic neuritis, NMOSD neuromyelitis optica spectrum disorders, pRNFL peripapillary retinal nerve fiber layer, TMV total macular volume
Fig. 3
Fig. 3
Primary retinal pathology in NMOSD. A Macular microcysts in the INL of a NMOSD after ON (arrows: microcysts). B (1) OCT and (2) mean shape surface reconstruction with shape variation (color code: thickness in mm + 1 SD) of healthy cohort compared to C (1) OCT and (2) mean shape surface reconstruction with shape variation of broadened fovea surface in a NMOSD cohort. ON optic neuritis, NMOSD neuromyelitis optica spectrum disorders, INL inner nuclear layer, SD standard deviation
See this image and copyright information in PMC

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