Quantification of retinal neural loss in patients with neuromyelitis optica and multiple sclerosis with or without optic neuritis using optical coherence tomography
Mario L.R. Monteiro 1,
Danilo B. Fernandes 2,
Samira L. Apostolos-Pereira 3 and
Dagoberto Callegaro 3
Author Affiliations
1 Division of Ophthalmology and Laboratory of Investigation in Ophthalmology (LIM 33), University of Sao Paulo Medical School, Av. Angelica 1757 conj. 61, Sao Paulo, Sao Paulo, 01227-200, Brazil
2 Division of Ophthalmology and Laboratory of Investigation in Ophthalmology (LIM 33), University of Sao Paulo Medical School, Sao Paulo, Brazil
3 Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil
Division of Ophthalmology and Laboratory of Investigation in Ophthalmology (LIM 33), University of Sao Paulo Medical School, Av. Angelica 1757 conj. 61, Sao Paulo, Sao Paulo, 01227-200, Brazil mlrmonteiro@terra.com.br
Abstract
Objective: To compare retinal nerve fiber layer (RNFL) and macular thickness measurements in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO) with or without history of optic neuritis and in controls using Fourier-domain (FD) optical coherence tomography (OCT). Methods: Patients with MS (n=60), NMO (n=33), longitudinal extensive transverse myelitis (LETM) (n=28) and healthy controls (n=41) were submitted to ophthalmic examination, including automated perimetry, and to FD-OCT RNFL and macular thickness measurements. Five groups of eyes were compared: MS with or without previous optic neuritis, NMO, LETM and controls. Correlation between OCT and visual field (VF) findings was investigated. Results: With regard to most parameters, RNFL and macular thickness measurements were significantly smaller in eyes of each group of patients compared to controls. MS eyes with optic neuritis did not differ significantly from MS eyes without optic neuritis, but measurements were smaller in NMO eyes than in all other groups. RNFL (but not macular thickness) measurements were significantly smaller in LETM eyes than in controls. While OCT abnormalities were significantly correlated with VF loss in both NMO/LETM and MS, the correlation was much stronger in the former. Conclusion: Although FD-OCT RNFL and macular thickness measurements can reveal subclinical or optic neuritis-related abnormalities in both NMO-spectrum and MS patients, abnormalities are predominant in the macula of MS patients and in RFNL measurements in NMO patients. The correlation between OCT and VF abnormalities was stronger in NMO than in MS, suggesting the two conditions differ regarding structural and functional damage.
Copyright © 2012 by Association for Research in Vision and Ophthalmology
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