Differing Structural and Functional Patterns of Optic Nerve Damage in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder
| Autor: | Ariadna Fontes, Yuyi You, Sukanya Arunachalam, Michael Barnett, Ting Shen, Clare L. Fraser, John Parratt, Ling Zhu, Alexander Klistorner, Chenyu Wang, Joshua Barton, Vivek Gupta, Nitin Chitranshi, Sidong Liu, Stuart L. Graham, Con Yiannikas |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Retinal Ganglion Cells medicine.medical_specialty Multiple Sclerosis Optic Neuritis Visual acuity genetic structures Anterior Visual Pathway Visual Acuity Axonal loss Nerve fiber layer 03 medical and health sciences 0302 clinical medicine Ophthalmology Humans Medicine Visual Pathways Optic neuritis 030304 developmental biology 0303 health sciences Neuromyelitis optica business.industry Multiple sclerosis Neuromyelitis Optica Optic Nerve Middle Aged medicine.disease Magnetic Resonance Imaging Axons eye diseases Cross-Sectional Studies medicine.anatomical_structure 030221 ophthalmology & optometry Optic nerve Evoked Potentials Visual Female sense organs medicine.symptom business Tomography Optical Coherence |
| Zdroj: | Ophthalmology. 126:445-453 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2018.06.022 |
| Popis: | To assess differential patterns of axonal loss and demyelination in the optic nerve in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD).Cross-sectional study.One hundred ninety-two participants, including 136 MS patients (272 eyes), 19 NMOSD patients (38 eyes), and 37 healthy control participants (74 eyes).All participants underwent spectral-domain OCT scans and multifocal visual evoked potential (mfVEP) recordings. High-resolution magnetic resonance imaging (MRI) with the diffusion protocol also was performed in all patients.Ganglion cell-inner plexiform layer (GCIPL) thickness and mfVEP amplitude and latency at 5 eccentricities; global and temporal retinal nerve fiber layer thickness.In optic neuritis (ON) eyes, the NMOSD patients had more severe GCIPL loss (P0.001) and mfVEP amplitude reduction (P0.001) compared with MS patients, whereas in contrast, mfVEP latency delay was more evident in MS patients (P0.001). The NMOSD patients showed more morphologic and functional loss at the foveal to parafoveal region, whereas the MS patients showed evenly distributed damage at the macula. Correlation analysis demonstrated a strong structure-function (OCT-mfVEP) association in the NMOSD patients, which was only moderate in the MS patients. In non-ON (NON) eyes, the MS patients showed significantly thinner GCIPL than controls (P0.001), whereas no GCIPL loss was observed in NON eyes in NMOSD. In addition, a significant correlation was found between all OCT and mfVEP measures in MS patients, but not in NMOSD patients. MRI demonstrated significant lesional load in the optic radiation in MS compared to NMOSD eyes (P = 0.002), which was related to the above OCT and mfVEP changes in NON eyes.Our study demonstrated different patterns of ON damage in NMOSD and MS. In MS, the ON damage was less severe, with demyelination as the main pathologic component, whereas in NMOSD, axonal loss was more severe compared with myelin loss. The disproportional mfVEP amplitude and latency changes suggested predominant axonal damage within the anterior visual pathway as the main clinical feature of NMOSD, in contrast to MS, where demyelination spreads along the entire visual pathway. |
| Databáze: | OpenAIRE |
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