Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Ziccardi, Lucia; Barbano, Lucilla; Boffa, Laura; Albanese, Maria; Grzybowski, Andrzej; Falsini, Benedetto; Centonze, Diego; Parisi, Vincenzo

doi:10.20944/preprints202007.0152.v1

Cited by 6 publications

(7 citation statements)

References 43 publications

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“…The involvement of macular preganglionic elements’ function, during the neurodegenerative process of MS, is controversial and there are few references on this topic. 46 …”

Section: Discussionmentioning

confidence: 99%

OCT Variability Prevents Their Use as Robust Biomarkers in Multiple Sclerosis

Para-Prieto

Martín

Crespo

et al. 2021

OPTH

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Objective: To evaluate the agreement between the peripapillary retinal nerve fiber layer (pRNFL) and foveal thickness (FT) measurements among three different spectral domainoptical coherence tomography (SD-OCT) instruments in a sample of multiple sclerosis (MS) patients and a healthy age-matched control group. Methods: An observational cross-sectional study with three groups: healthy subjects and MS patients w/w a previous clinical diagnosis of optic neuritis (ON) was conducted. The pRNFL and FT were measured using three different SD-OCT instruments (OCT PRIMUS 200 and OCT CIRRUS 500 SD-OCT [Carl Zeiss Meditec] and OCT 3D 2000 [Topcon]). Results: Twenty eyes from 10 healthy subjects matched in age with MS patients without a previous history of eye disease and 62 MS eyes from 31 MS patients (29 eyes without history of ON and 33 eyes with history of ON) were enrolled. Healthy subjects and MS patients without ON did not show differences between the pRNFL and FT thickness (P>0.99) with any of the instruments. However, MS eyes with a previous episode of ON showed thinner pRNFL and FT (P<0.01). PRIMUS and CIRRUS OCT showed better agreement of the pRNLF and FT in both healthy and MS eyes. However, 3D OCT showed less agreement in the pRNFL measurement with CIRRUS in both healthy and MS eyes. Interpretation: Although OCT is a valuable technology to improve MS patient assessment, differences between devices must be taken into account. It is necessary to create an international group that standardizes the measurement conditions and above all that provides reference bases for normal subjects.

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“…The involvement of macular preganglionic elements’ function, during the neurodegenerative process of MS, is controversial and there are few references on this topic. 46 …”

Section: Discussionmentioning

confidence: 99%

OCT Variability Prevents Their Use as Robust Biomarkers in Multiple Sclerosis

Para-Prieto

Martín

Crespo

et al. 2021

OPTH

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Section: Methodsmentioning

confidence: 99%

“…The mfERG was recorded by using a modified version of the Espion system (Diagnosys UK Ltd; Histon, Cambridge, UK) following the 2011 International Society for Clinical Electrophysiology of Vision (ISCEV) standards [25] and by using the same previously published method [28]. Briefly, the multifocal stimulus, consisting of 61 scaled hexagons, was displayed on a highresolution, black-and-white 32 00 LCD monitor with a frame rate of 75 Hz.…”

Section: Multifocal Electroretinogram Recordingmentioning

confidence: 99%

“…A ‘kernel analysis’ applied to mfERG responses can be used to assess nonlinear functions of the visual system mainly originating from selected population of pre-ganglionic (photoreceptors and bipolar cells) elements [ 26 , 27 ]. Recently [ 28 ], it was reported that in patients with RR-MS, in the absence of optic neuritis (ON) or when after an episode of ON a complete recovery of visual acuity is reached, there is an absence of cone-related pre-ganglionic component dysfunction and this was detectable by mfERG responses that were not significantly different when compared to normal control ones.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Macular Function by Multifocal Electroretinogram in Patients with Multiple Sclerosis Treated with Fingolimod

et al. 2021

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Introduction: This study aimed to evaluate whether treatment with fingolimod (FTY) may induce functional changes on the macular preganglionic retinal elements in patients affected by relapsing-remitting multiple sclerosis (RR-MS) without optic neuritis (ON). Methods: This case-control observational and retrospective study assessed multifocal electroretinogram (mfERG) responses from 35 healthy controls (mean age 43.58 ± 5.76 years), 41 patients with RR-MS without ON (mean age 40.64 ± 4.83 years, MS-noFTY group), and from 21 patients with RR-MS without ON (mean age 42.38 ± 12.34 years) and treated with fingolimod (GilenyaÒ, Novartis Europharm, 0.5 mg/day) (MS-FTY group). MfERG N1 and P1implicit times (ITs), and N1-P1 response amplitude densities (RADs) were measured from concentric rings (R) with increasing foveal eccentricity: 0-5°(R1), 5-10°(R2), 10-15°(R3), 15-20°(R4), 20-25°(R5). We considered R1 and R2 as ''central macular areas'' and R3, R4 and R5 as ''more eccentric retinal areas''. In the MS-FTY group, mfERG recordings were performed between 6 and 12 months (mean 7.2 ± 1.5 months) from the start of FTY. Results: In the MS-FTY group, the mean values of mfERG N1 and P1 ITs and RADs detected in both central macular areas (R1 and R2) and in more eccentric retinal areas (R3, R4 and R5) were not significantly different (p [ 0.01) with respect to those of control and MS-noFTY groups. Conclusions: Our mfERG results suggest that the chronic use of FTY does not induce a dysfunction of pre-ganglionic retinal elements located in the 0-25°of central retina. Since FTY does not cause any retinal functional abnormality, we suggest that FTY treatment could not produce any toxic effect on pre-ganglionic retinal elements even in the absence of macular oedema.Lucilla Barbano and Lucia Ziccardi equal contribution.

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“…In DC and DP eyes, mfERGs were recorded according to the standard ISCEV [24] and our previously published method [9,12,[25][26][27].…”

Section: Mferg Recordingsmentioning

confidence: 99%

Citicoline and Vitamin B12 Eye Drops in Type 1 Diabetes: Results of a 36-Month Pilot Study Evaluating Macular Electrophysiological Changes

et al. 2021

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Introduction: Our aim was to evaluate the effects of 36 months of treatment with citicoline and vitamin B 12 eye drops on macular function in patients with type 1 diabetes (DM1) with mild signs of non-proliferative diabetic retinopathy (NPDR). Methods: A prospective, randomized, interventional, monocentric, double-masked study was conducted. Twenty patients with DM1 were enrolled and randomly divided into two groups: the DC group (10 patients; mean age ± standard deviation 46.86 ± 8.78 years) in which one eye of each patient was treated with citicoline and vitamin B 12 eye drops (OMK2 Ò , Omikron Italia srl, Italy, one drop thrice daily) for a period of 36 months; the DP group (10 patients; mean age ± standard deviation 47.89 ± 7.74 years) in which one eye of each patient was treated with placebo (eye drops containing hypromellose 0.3%, one drop thrice daily) for a period of 36 months. A total of 18 eyes (10 from the DP and 8 from the DC group, respectively) completed the study. In both groups, multifocal electroretinogram (mfERG) recordings were assessed at baseline and after 36 months. In mfERG analysis, the N1-P1 response amplitude density (RAD) evaluated in the 0-2.5°(ring 1), in the 2.5-5°(ring 2), in the 5-10°(ring 3), and in the 0-10°( ring 1 ? ring 2 ? ring 3) were considered. Results: With respect to baseline, after 36 months of follow-up, the mfERG RADs recorded in R1, R2, R3, and R1 ? R2 ? R3 were significantly increased (i.e., R1 ? R2 ? R3 RAD from 21.552 ± 2.522 nV/degree 2 at baseline to 26.912 ± 2.850 nV/degree 2 at 36 months) in DC eyes, whereas in DP eyes they were significantly reduced (i.e., R1 ? R2 ? R3 RAD from 21.033 ± 3.574 nV/degree 2 at baseline to 16.151 ± 3.571 nV/degree 2 at 36 months). Conclusions: This study indicates that patients with NPDR treated with citicoline and vitamin B 12 eye drops for a 36-month period achieved an improvement of the macular bioelectrical responses detectable by mfERG recordings. By contrast, during the same period of follow-up, patients with NPDR treated with placebo showed a worsening of the macular function.

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Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Cited by 6 publications

References 43 publications

OCT Variability Prevents Their Use as Robust Biomarkers in Multiple Sclerosis

OCT Variability Prevents Their Use as Robust Biomarkers in Multiple Sclerosis

Assessment of Macular Function by Multifocal Electroretinogram in Patients with Multiple Sclerosis Treated with Fingolimod

Citicoline and Vitamin B12 Eye Drops in Type 1 Diabetes: Results of a 36-Month Pilot Study Evaluating Macular Electrophysiological Changes

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