Clinical effects associated with five-year retinal nerve fiber layer thinning in multiple sclerosis

Jakimovski, Dejan; Zivadinov, Robert; Vaughn, Caila B.; Ozel, Osman; Weinstock‐Guttman, Bianca

doi:10.1016/j.jns.2021.117552

Cited by 11 publications

(10 citation statements)

References 37 publications

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“…Limited (up to 2 years) observation periods, 28,29 mixed patient's cohorts, 29-31 or lack of validation of the degree of chronic demyelination 29-31 may explain why some of the previously reported studies failed to detect accelerated axonal loss in the eyes of patients with RRMS with a history of ON. The most recent study, 32 which followed mixed cohort of patients with MS for 5 years, showed a significant relationship between RNFL thinning and previous history of ON only in the progressive, but not in patients with relapsing-remitting MS. However, contrary to patients with progressive MS, the baseline degree of optic nerve damage caused by acute ON (and, therefore, degree of chronic demyelination) in ON eyes of patients with RRMS was minimal, if any.…”

Section: Discussionmentioning

confidence: 99%

Long-term Effect of Permanent Demyelination on Axonal Survival in Multiple Sclerosis

Klistorner

You

et al. 2022

Neurol Neuroimmunol Neuroinflamm

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Background and ObjectivesTo investigate the long-term effect of permanent demyelination on axonal attrition by examining an association between intereye asymmetry of the multifocal visual evoked potential (mfVEP) latency delay and subsequent thinning of retinal ganglion cell axons in patients with a long-standing history of unilateral optic neuritis (ON).MethodsOnly patients with a significant degree of chronic demyelination (intereye latency asymmetry >5 ms) were included in this study. The level of optic nerve demyelination was estimated at baseline by the latency delay of mfVEP, while the degree of axonal loss was assessed by thinning of the retinal nerve fiber layer (RNFL) thickness between baseline and follow-up visits. Low-contrast visual acuity (LCVA) was also evaluated at baseline and follow-up. Patients were examined twice with an average interval of 6.1 ± 1.4 years.ResultsFrom 85 examined patients with multiple sclerosis, 28 satisfied inclusion criteria. Latency of the mfVEP was delayed, and RNFL thickness was reduced in ON eyes compared with fellow eyes at both visits. There was significant correlation between latency asymmetry and baseline or follow-up intereye RNFL thickness asymmetry. Intereye asymmetry of LCVA at baseline correlated with baseline latency asymmetry of mfVEP and baseline asymmetry of RNFL thickness. Latency of the mfVEP in ON eyes improved slightly during the follow-up period, whereas latency of the fellow eye remained stable. By contrast, RNFL thickness significantly declined in both ON and fellow eyes during the follow-up period. The rate of RNFL thinning in ON eyes, however, was more than 2 times faster compared with the fellow eyes (p < 0.001). Furthermore, baseline latency asymmetry significantly correlated with the rate of RNFL thinning in ON eyes during the follow-up (p < 0.001), explaining almost half of the variability of temporal RNFL progression. For each millisecond of latency delay (i.e., ∼0.5 mm of demyelination along the optic nerve), temporal RNFL thickness was annually reduced by 0.05%.DiscussionOur study provides clear in vivo evidence that chronic demyelination significantly accelerates axonal loss. However, because this process is slow and its effect is mild, long-term monitoring is required to establish and confidently measure the neurodegenerative consequences of demyelination.

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Section: Discussionmentioning

confidence: 99%

Long-term Effect of Permanent Demyelination on Axonal Survival in Multiple Sclerosis

Klistorner

You

et al. 2022

Neurol Neuroimmunol Neuroinflamm

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“…At partial 2 (η2) values, 0.01 is considered low potency, 0.06 is considered average potency, and 0.14 and above is considered high potency (Jakimovski et al, 2021 ). According to the partial effect size value, an average effect in the interval test and a high potential effect in the post-test results were detected in favour of the DGBLL (η2 (interval test) = 0.09; η2 (post-test) = 0.50).…”

Section: Resultsmentioning

confidence: 99%

A triangulation method on the effectiveness of digital game-based language learning for vocabulary acquisition

Kazu

Kuvvetli

2023

Educ Inf Technol

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This research aimed to explore the views of 8 th grade students on digital game-based English language learning as a foreign language (EFL). A total of 69 students between the ages of 12 and 14 participated in the study. Students' vocabulary acquisition skills were tested using a web 2.0 application called "Quizziz." The study utilized a triangulation method in which the results of a quasi-experiment and the metaphorical perceptions of the learners were obtained. The results of the tests were recorded at two-week intervals, and students’ reactions to the results were collected using a data collection tool. The study used a pre-test, post-test, and control group design. The experimental and control groups took a pre-test before the study began. The experimental group then practiced vocabulary using Quizziz, while the control group practiced vocabulary by memorizing it in their mother tongue. The post-test results showed significant differences between the control and experimental groups. In addition, content analysis was used to analyse the data, with metaphors being grouped and frequencies calculated. The students generally expressed positive views on digital game-based EFL, stating that it was highly successful and that in-game power-ups, competing with other students, and receiving rapid feedback improved their motivation.

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“…Disease progression without a relapse, typical for primary progressive (PPMS) or secondary progressive MS (SPMS), is also associated with increased GCIPL and pRNFL thickness loss [40]. This could, to a certain extent, explain why progressive MS patients show faster annual pRNFL and GCIPL thinning and lower values at baseline compared to RRMS [28, [41][42][43]. As mentioned before, GCIPL and pRNFL can be correlated with brain atrophy and spinal cord atrophy, cortical lesion volume, and leptomeningeal enhancement [44][45][46][47][48].…”

Section: Long-term Oct Changes In Ms Patientsmentioning

confidence: 99%

“…From the group of highly effective disease-modifying therapies, natalizumab showed a significantly reduced pRNFL thinning compared to first-line injectables [ 42 ]. While alemtuzumab exhibited stable RNFL and GCIPL parameters, proving a certain neuroprotective effect, rituximab showed increased GCIPL atrophy rates during the first 12 months of treatment but subsequently decreased atrophy rates similar to healthy controls in a study with a small case number [ 77 ].…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects

Olbert

Struhal

2022

Wien Med Wochenschr

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SummaryOptical coherence tomography (OCT) is of increasing interest in the clinical assessment of multiple sclerosis (MS) patients beyond the scope of clinical studies. In this narrative review, we discuss novel changes of OCT parameters during acute optic neuritis and the disease course of MS patients. OCT images document the changes of retinal layers during an episode of acute optic neuritis and can therefore provide valuable insights into the pathophysiology. Moreover, MS patients show progredient thinning of retinal layers throughout the disease. The thinning is accelerated through relapses as well as disease progression without relapse. The OCT parameters are also associated with clinical outcome parameters, including disability, cognitive function, and brain atrophy. The impact of disease-modifying therapies on OCT parameters is the subject of ongoing research and depends on the agent used. Additional data are still necessary before OCT parameters can be implemented in the clinical standard of care of MS patients.

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Clinical effects associated with five-year retinal nerve fiber layer thinning in multiple sclerosis

Cited by 11 publications

References 37 publications

Long-term Effect of Permanent Demyelination on Axonal Survival in Multiple Sclerosis

Long-term Effect of Permanent Demyelination on Axonal Survival in Multiple Sclerosis

A triangulation method on the effectiveness of digital game-based language learning for vocabulary acquisition

Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects

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