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. 2019 Dec;25(14):1878-1887.
doi: 10.1177/1352458518815597. Epub 2018 Dec 3.

Spinal cord and infratentorial lesions in radiologically isolated syndrome are associated with decreased retinal ganglion cell/inner plexiform layer thickness

Angeliki Filippatou  1 , Thomas Shoemaker  1 , Megan Esch  1 , Madiha Qutab  1 , Natalia Gonzalez-Caldito  1 , Jerry L Prince  2 , Ellen M Mowry  1 , Peter A Calabresi  1 , Shiv Saidha  1 , Elias S Sotirchos  1
Affiliations

Spinal cord and infratentorial lesions in radiologically isolated syndrome are associated with decreased retinal ganglion cell/inner plexiform layer thickness

Angeliki Filippatou et al. Mult Scler. 2019 Dec.

Abstract

Background: The role of retinal imaging with optical coherence tomography (OCT) in assessing individuals with radiologically isolated syndrome (RIS) remains largely unexplored.

Objective: To assess retinal layer thicknesses in RIS and examine their associations with clinical features suggestive of increased risk for conversion to multiple sclerosis (MS).

Methods: A total of 30 RIS subjects and 60 age- and sex-matched healthy controls (HC) underwent retinal imaging with spectral-domain OCT, followed by automated segmentation of retinal layers.

Results: Overall, retinal layer thicknesses did not differ between RIS and HC. However, RIS subjects with spinal cord (SC) lesions had lower ganglion cell + inner plexiform layer (GCIP) thickness compared to HC (-4.41 μm; p = 0.007) and RIS without SC lesions (-3.53 μm; p = 0.041). Similarly, RIS subjects with infratentorial (IT) brain lesions had lower GCIP thickness compared to HC (-4.07 μm; p < 0.001) and RIS without IT lesions (-3.49 μm; p = 0.029). Multivariate analyses revealed that the presence of SC or IT lesions were independently associated with lower GCIP thickness in RIS (p = 0.04 and p = 0.03, respectively). Other patient characteristics, including sex, abnormal cerebrospinal fluid, and presence of gadolinium-enhancing or juxtacortical lesions, were not associated with retinal layer thicknesses.

Conclusion: The presence of SC or IT lesions in RIS may be associated with retinal neuro-axonal loss, supporting the presence of more disseminated disease.

Keywords: Multiple sclerosis; demyelination; optical coherence tomography; radiologically isolated syndrome; retina; spinal cord.

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Conflict of interest statement

Conflict of interest:

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Study Profile JHU: Johns Hopkins University; MS: multiple sclerosis; MRI: magnetic resonance imaging; OCT: optical coherence tomography; RIS: radiologically isolated syndrome; TNF: tumor necrosis factor
Figure 2.
Figure 2.
Boxplots of GCIP thickness in HC and RIS by presence of spinal cord lesions (A) and infratentorial lesions (B) GCIP: ganglion cell + inner plexiform layer; HC: healthy controls; RIS: radiologically isolated syndrome
Figure 3.
Figure 3.
Relationship of retinal layer thicknesses with age in HC and RIS. A: GCIP; B: p-RNFL; C: INL HC: healthy controls; RIS: radiologically isolated syndrome; GCIP: ganglion cell + inner plexiform layer; p-RNFL: peri-papillary retinal nerve fiber layer; INL: inner nuclear layer
See this image and copyright information in PMC

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