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. 2019 Dec;39(4):444-450.
doi: 10.1097/WNO.0000000000000768.

Macular Ganglion Cell and Inner Plexiform Layer Thickness Is More Strongly Associated With Visual Function in Multiple Sclerosis Than Bruch Membrane Opening-Minimum Rim Width or Peripapillary Retinal Nerve Fiber Layer Thicknesses

James Nguyen  1 , Alissa Rothman, Natalia Gonzalez, Ama Avornu, Esther Ogbuokiri, Laura J Balcer, Steven L Galetta, Elliot M Frohman, Teresa Frohman, Ciprian Crainiceanu, Peter A Calabresi, Shiv Saidha
Affiliations

Macular Ganglion Cell and Inner Plexiform Layer Thickness Is More Strongly Associated With Visual Function in Multiple Sclerosis Than Bruch Membrane Opening-Minimum Rim Width or Peripapillary Retinal Nerve Fiber Layer Thicknesses

James Nguyen et al. J Neuroophthalmol. 2019 Dec.

Abstract

Background: Optical coherence tomography (OCT) measurements of ganglion cell + inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thicknesses are associated with visual function (VF) and disability in multiple sclerosis (MS). However, the value of measuring Bruch membrane opening-minimum rim width (BMO-MRW) thickness in MS remains unclear.

Methods: Sixty-eight patients with MS and 22 healthy controls (HCs) underwent spectral domain OCT, 100%-contrast visual acuity (VA), 2.5%- and 1.25%-contrast letter acuity (LA), and Expanded Disability Status Scale (EDSS) testing. Mixed-effects linear regression models, accounting for within-subject, intereye correlations, were used to assess relationships.

Results: The MS cohort exhibited significantly lower BMO-MRW (P = 0.01), pRNFL at 3.7-, 4.1-, and 4.7-mm diameters surrounding the optic disc (P < 0.001 for all), and GCIPL (P < 0.001) thicknesses than HCs. BMO-MRW thickness was associated with 100%-VA (P < 0.001, R = 0.08), 2.5%-LA (P < 0.001; R = 0.13), and 1.25%-LA (P = 0.002; R = 0.11). All measured pRNFL thicknesses were associated with high- and low-contrast VF (all: P < 0.001). GCIPL thickness was more strongly associated with 100%-VA (P < 0.001; R = 0.23), 2.5%-LA (P < 0.001; R = 0.27), and 1.25%-LA (P < 0.001; R = 0.21) than the other OCT measures assessed. All OCT measures were significantly, but weakly, associated with EDSS scores.

Conclusions: BMO-MRW and pRNFL thicknesses are reduced and associated with VF and disability in MS, but GCIPL thickness is a stronger marker of visual impairment. Our findings corroborate the utility of OCT in providing valuable information regarding the MS disease process.

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Conflict of interest statement

DECLARATION OF CONFLICTS OF INTEREST

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Panel A depicts a Spectralis optical coherence tomography (OCT) derived fundus image showing the optic disc with corresponding retinal microvasculature, as well as 24 radial slices of the peri-papillary region and 3 circular scans at 3.5 mm, 4.1 mm, and 4.7 mm diameters surrounding the optic disc (Panel A). The corresponding OCT image (Panel B) shows the Bruch’s membrane opening – minimum rim width (BMO-MRW) flanking the optic cup (blue arrows). Scans were acquired from a healthy participant
Fig. 2
Fig. 2
Adjusted variable plots comparing the strength of significant associations between OCT-derived average Bruch’s membrane opening minimum rim width (BMO-MRW; upper panel), average ganglion cell + inner plexiform layer (GCIP; lower left panel), and peri-papillary retinal nerve fiber layer (pRNFL; lower right panel) thicknesses and 2.5%-contrast letter acuity in MS, accounting for age, sex, disease duration, and history of optic neuritis. Consistent with a tighter distribution fit along the linear regression line, GCIP thickness exhibits the highest R2-value. p-values and R2-values were derived from mixed-effect linear regression models, adjusting for within-subject inter-eye correlation, and accounting for age, sex, disease duration, and history of optic neuritis
See this image and copyright information in PMC

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