Optical coherence tomography differs in neuromyelitis optica compared with multiple sclerosis
Abstract
Background: Neuromyelitis optica (NMO) is associated with destructive inflammatory lesions, resulting in necrosis and axonal injury. Disability from multiple sclerosis (MS) is due to a combination of demyelination and varying axonal involvement. Optical coherence tomography (OCT), by measuring retinal nerve fiber layer (RNFL) as a surrogate of axonal injury, has potential to discriminate between these two conditions.
Methods: Included were 22 subjects with NMO or NMO spectrum disorders and 47 with MS. Seventeen subjects with NMO and all with MS had a remote history of optic neuritis (ON) in at least one eye, at least 6 months before OCT. Linear mixed modeling was used to compare the two diagnoses for a given level of vision loss, while controlling for age, disease duration, and number of episodes of ON.
Results: After ON, NMO was associated with a thinner mean RNFL compared to MS. This was found when controlling for visual acuity (56.7 vs 66.6 μm, p = 0.01) or for contrast sensitivity (61.2 vs 70.3 μm, p = 0.02). The superior and inferior quadrants were more severely affected in NMO than MS.
Conclusions: Optic neuritis (ON) within neuromyelitis optica (NMO) is associated with a thinner overall average retinal nerve fiber layer compared to multiple sclerosis, with particular involvement of the superior and inferior quadrants. This suggests that NMO is associated with more widespread axonal injury in the affected optic nerves. Optical coherence tomography can help distinguish the etiology of these two causes of ON, and may be useful as a surrogate marker of axonal involvement in demyelinating disease.
Get full access to this article
View all available purchase options and get full access to this article.
REFERENCES
1.
Wingerchuk DM, Hogancamp WF, O'Brien PC, Weinshenker BG. The clinical course of neuromyelitis optica (Devic's syndrome). Neurology 1999;53:1107–1114.
2.
Weinshenker BG. Neuromyelitis optica is distinct from multiple sclerosis. Arch Neurol 2007;64:899–901.
3.
Wingerchuk DM, Weinshenker BG. Neuromyelitis optic: clinical predictors of a relapsing course and survival. Neurology 2003;60:848–853.
4.
Stadelman C, Bruck W. Lessons from the neuropathology of atypical forms of multiple sclerosis. Neurol Sci 2004;25 suppl 4:S319–S322.
5.
Mandler RN, Davis LE, Jeffery DR, Kornfeld MK. Devic's neuromyelitis optica: a clinical pathological study of 8 patients. Ann Neurol 1993;34:162–168.
6.
Roemer SF, Parisi JE, Lennon VA, et al. Pattern specific loss of aquaporing-4 immunoreactivity distinguishes neuromyelitis optica from multiple sclerosis. Brain 2007;130:1194–1205.
7.
Lucchinetti CF, Mandler RN, McGavern D, et al. A role for humoral mechanisms in the pathogenesis of Devic's neuromyelitis optica. Brain 2002;125:1450–1461.
8.
Lucchinetti C, Parisi J, Bruck W. The pathology of multiple sclerosis. Neurol Clin 2005;23:77–105.
9.
Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science 1991;254:1178–1181.
10.
Toth CA, Narayan DG, Boppart ST, et al. A comparison of retinal morphology viewed by optical coherence tomography and by light microscopy. Arch Ophthalmol 1997;115:1425–1428.
11.
Chen TC, Cense B, Miller JW, et al. Histologic correlation of in vivo optical coherence tomography images of the human retina. Am J Ophthalmol 2006;141:1165–1168.
12.
Yucel YH, Gypta N, Kalichman MW, et al. Relationship of optic disc topography to optic nerve fiber number in glaucoma. Arch Ophthalmol 1998;116:493–497.
13.
Kerrison JB, Flynn T, Green R. Retinal pathologic changes in multiple sclerosis. Retina 1994;14:445–451.
14.
Elbol P, Work K. Retinal nerve fiber layer in multiple sclerosis. Acta Ophthalmol 1990;68:481–486.
15.
Frisen LF, Boyt WF. Insidious atrophy of retinal nerve fibers in multiple sclerosis. Arch Ophthalmol 1974;92:91–97.
16.
Steel DH, Waldock A. Measurement of the retinal nerve fiber layer with the scanning laser polarimetry in patients with previous demyelinating optic neuritis. J Neurol Neurosurg Psychiatry 1998;64:505–509.
17.
Pulicken M, Gordon-Lipkin E, Balcer LJ, Frohman E, Cutter G, Calabresi PA. Optical coherence tomography and disease subtype in multiple sclerosis. Neurology 2007;69:2085–2092.
18.
Trip SA, Schlottmann PG, Jones SJ, et al. Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis. Ann Neurol 2005;58:383–391.
19.
Trip SA, Schlottmann PG, Jones SJ, et al. Optic nerve atrophy and retinal nerve fiber layer thinning following optic neuritis: evidence that axonal loss is a substrate of MRI-detected atrophy. NeuroImage 2006;31:286–293.
20.
Pueyo V, Martin J, Fernandez J, et al. Axonal loss in the retinal nerve fiber layer in patients with multiple sclerosis. Mult Scler 2008;14:609–614.
21.
Costello F, Coupland S, Hodge W, et al. Quantifying axonal loss after optic neuritis with optical coherence tomography. Ann Neurol 2006;59:963–969.
22.
Gordon-Lipkin E, Chodkowski B, Reich DS, et al. Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology 2007;69:1603–1609.
23.
Sepulcre J, Murie-Fernandez M, Salinas-Alaman A, Garcia-Layana A, Bejarano B, Villoslada P. Diagnostic accuracy of retinal abnormalities in predicting disease activity in MS. Neurology 2007;68:1488–1494.
24.
Fisher JB, Jacobs DA, Markowitz CE, et al. Relation of visual function to retinal nerve fiber layer thickness in multiple sclerosis. Ophthalmology 2006;113:324–332.
25.
Frohman E, Costello F, Zivadinov R, et al. Optical coherence tomography in multiple sclerosis. Lancet Neurol 2006;5:853–563.
26.
Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005;202:473–477.
27.
Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology 2006;66:1485–1489.
28.
Costello F, Hodge W, Pan Y, Eggenberger E, Coupland S, Kardon RH. Tracking retinal nerve fiber layer loss after optic neuritis: a prospective study using optical coherence tomography. Mult Scler 2008;14:893–905.
29.
Baier ML, Cutter GR, Rudick RA, et al. Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis. Neurology 2005;64:992–995.
30.
Balcer LJ, Baier ML, Pelak VS, et al. New low-contrast vision charts: reliability and test characteristics in patients with multiple sclerosis. Mult Scler 2000;6:163–171.
31.
International Council of Ophthalmology. Sydney, Australia; April 20, 2002. Available at: www.icoph.org/pdf/visualstanres.pdf. Accessed February 10, 2009.
32.
De Seze J, Blanc F, Jeanjean L, et al. Optical coherence tomography in neuromyelitis optica. Arch Neurol 2008;65:920–923.
33.
Merle H, Olindo S, Donnio A, Richer R, Smadja D, Cabre P. Retinal peripapillary nerve fiber layer thickness in neuromyelitis optica. IOVS 2008;49:4412–4417.
34.
Charcot JM. Histologie de la sclerose en plaques. Gaz Hop Civils Militaires 1868;140:554–555.
35.
Naismith RT, Xu J, Tutlam NT, et al. Disability in optic neuritis correlates with diffusion tensor-derived directional diffusivities. Neurology 2009; 72:589–594.
36.
Wu GF, Schwartz ED, Lei T, et al. Relation of vision to global and regional brain MRI in multiple sclerosis. Neurology 2007;69:2128–2135.
Information & Authors
Information
Published In
Copyright
© 2009.
Publication History
Published online: March 23, 2009
Published in print: March 24, 2009
Authors
Metrics & Citations
Metrics
Citations
Download Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.
Cited By
- Utility of optical coherence tomography in patients of central immune mediated demyelinating diseases – A prospective study, eNeurologicalSci, 31, (100464), (2023).https://doi.org/10.1016/j.ensci.2023.100464
- Use of retinal optical coherence tomography to differentiate suspected neuromyelitis optica spectrum disorder from multiple sclerosis: A cross-sectional study, Multiple Sclerosis and Related Disorders, 68, (104160), (2022).https://doi.org/10.1016/j.msard.2022.104160
- Optical coherence tomography angiography (OCTA) in differential diagnosis of aquaporin-4 antibody seronegative NMOSD and multiple sclerosis, Multiple Sclerosis and Related Disorders, 58, (103503), (2022).https://doi.org/10.1016/j.msard.2022.103503
- Imaging of the optic nerve: technological advances and future prospects, The Lancet Neurology, 21, 12, (1135-1150), (2022).https://doi.org/10.1016/S1474-4422(22)00173-9
- Literatur, Multiple Sklerose, (468-512), (2022).https://doi.org/10.1016/B978-3-437-22085-2.00028-8
- Imaging in Neuro-ophthalmology, Albert and Jakobiec's Principles and Practice of Ophthalmology, (4419-4447), (2022).https://doi.org/10.1007/978-3-030-42634-7_39
- Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study, Journal of Clinical Medicine, 10, 4, (609), (2021).https://doi.org/10.3390/jcm10040609
- Optical Coherence Tomography Reveals Longitudinal Changes in Retinal Damage Under Different Treatments for Neuromyelitis Optica Spectrum Disorder, Frontiers in Neurology, 12, (2021).https://doi.org/10.3389/fneur.2021.669567
- A novel investigation method for axonal damage in neuromyelitis optica spectrum disorder: In vivo corneal confocal microscopy, Multiple Sclerosis Journal - Experimental, Translational and Clinical, 7, 1, (205521732199806), (2021).https://doi.org/10.1177/2055217321998060
- Early age of onset predicts severity of visual impairment in patients with neuromyelitis optica spectrum disorder, Multiple Sclerosis Journal, 27, 11, (1749-1759), (2021).https://doi.org/10.1177/1352458520981736
- See more
Loading...
View Options
Get Access
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Personal login Institutional LoginPurchase Options
Purchase this article to get full access to it.