Multiple sclerosis: periphlebitis retinalis et cerebro-spinalis A correlation between periphlebitis retinalis and abnormal technetium brain scintigraphy

Engell, Tine; Hvidberg, Anders; Uhrenholdt, A

doi:10.1111/j.1600-0404.1984.tb07815.x

Cited by 19 publications

(6 citation statements)

References 12 publications

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“…These data, therefore, are consistent with the hypothe sis that the venular changes may be considered as a marker of disease activity, as also suggested by the studies of Engell et al [16,17], particularly in the early stages, given the good correlation found between PR and short duration of the disease. The different methodologies of case collection in the various studies which lead to a dif ferent probability of including patients with active disease may further explain the wide range of reported PR preva lence in MS [20],…”

Section: Discussionsupporting

confidence: 79%

“…Adams et al [12] suggested cerebral periphlebitis to be a precursor of plaque formations in surrounding tissues. A transitory breakdown of the bloodbrain barrier has been well documented at the time of dis ease activity by Tc-scintigraphy [13], CT scan [14], and more recently by MRI with gadolinium [15], Engell et al [16] found similar barrier damage in MS patients with PR, and analogous functional changes of the blood-retinal barrier during RP attacks, measured by vitreous fluorophotometry [ 17], Considering these simultaneous fea tures in the retina and the brain, and the similarity of their pathological aspects, it is reasonable to suppose a com mon etiopathogenesis for PR and CNS MS lesions, and to speculate that both ocular and cerebrum changes repre sent a primary phlebitic process that in the brain leads to demyelination, and in the retina, which is embryologically an extension of the CNS. stops at an early stage due to a lack of myelin in this site.…”

Section: Discussionmentioning

confidence: 99%

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Retinal Periphlebitis in Multiple Sclerosis: A Marker of Disease Activity?

Tola

Granieri²,

Casetta³

et al. 1993

Eur Neurol

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This study was performed in order to verify the prevalence of retinal periphlebitis and other ocular changes in a well-defined population of multiple sclerosis (MS) patients, and to correlate the presence of these features with some clinical variables which characterize the disease. 110 MS-affected subjects were submitted to a standard ophthalmologic examination including a biomicroscopical evaluation of the fundus oculi. The prevalence of retinal sheathing in MS patients was found to be nearly 36 %. It is significantly higher in patients evaluated in an active phase of the disease than in those examined in a stationary phase.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Retinal Periphlebitis in Multiple Sclerosis: A Marker of Disease Activity?

Tola

Granieri²,

Casetta³

et al. 1993

Eur Neurol

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“…7 Active retinal periphlebitis tends to occur simultaneously with blood-brain-barrier disruption in MS, 8 and may be a risk factor for relapses and gadolinium-enhancing lesions. 9 Intermediate uveitis, particularly parsplanitis, also occurs in up to 16% of MS patients.…”

Section: Introductionmentioning

confidence: 99%

Microcystic macular oedema, thickness of the inner nuclear layer of the retina, and disease characteristics in multiple sclerosis: a retrospective study

Saidha

Sotirchos

Ibrahim

et al. 2012

The Lancet Neurology

273

260

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Background Microcystic macular edema (MME) of the retinal inner nuclear layer (INL) has recently been identified in multiple sclerosis (MS) patients with optical coherence tomography (OCT). We aimed to determine if MME of the INL, and/or higher thickness of the INL, are associated with disease activity, or disability progression. Methods This retrospective study was performed at Johns Hopkins Hospital (between 09/2008 and 03/2012). 164 MS patients and 60 healthy-controls underwent serial OCT scans and clinical evaluation (including visual function). OCT scanning, including automated intra-retinal layer segmentation, yielded thicknesses of the retinal nerve fiber layer, ganglion cell layer (plus inner plexiform layer), INL (plus outer plexiform layer), and outer nuclear layer. MS patients also underwent annual brain MRI scans. Disability scores were compared with the Wilcoxon rank-sum test. Mixed-effects linear regression was used to compare OCT measures and letter-acuity scores. Logistic regression was used to examine the relationships of baseline OCT thicknesses with clinico-radiological parameters. Findings Mean follow-up (standard deviation) for MS patients and healthy-controls was 25·8-months (9·1-months) and 22·4-months (11·4-months) respectively. 10 MS patients (6·1% of the cohort) demonstrated MME during at least one study visit, but MME was not visible at baseline in 6 of these patients. MS patients with vs. without MME (151 MS patients) at any time during the study had higher baseline multiple sclerosis severity scores (p=0·032), although expanded disability status scale (EDSS) scores were not significantly different (p=0·097). MS eyes with MME (12 eyes) vs. without MME (302 eyes) had lower letter-acuity scores (100%-contrast: p=0·017; 2·5%-contrast: p=0·031; 1·25%-contrast: p=0·014), and higher INL thicknesses (p=0·003) at baseline. Higher baseline INL thickness in MS predicted the development of contrast-enhancing lesions (p=0·007), new T2 lesions (p=0·015), EDSS progression (p=0·034), and relapses (in relapsing-remitting MS; p=0·008) during the study. MME was not associated with disease activity during follow-up. Healthy-controls did not demonstrate MME. Interpretation Increased INL thickness on OCT, potentially representing inflammation of the unmyelinated retina, is associated with disease activity in MS. If this finding is confirmed, INL thickness may be a useful predictor of disease progression in MS. Funding National Multiple Sclerosis Society (TR3760-A-3, RG4212-A-4), National Eye Institute (R01-EY014993, R01-EY019473), Braxton Debbie Angela Dillon and Skip Donor Fund.

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“…These findings raise the possibility that the potential mechanism underlying the proposed occurrence of primary retinal pathology affecting the INL in MS may be inflammatory, 1, 2 such as related to retinal periphlebitis. Retinal periphlebitis is known to occur in up to 20% of MS patients, 10, 40 and it has previously been shown that active retinal periphlebitis and disruption of the blood-brain-barrier tend to occur simultaneously in MS. 41 Moreover, the presence of retinal periphlebitis in MS patients has been shown to be a risk factor for the subsequent development of relapses and gadolinium-enhancing lesions. 28 ONL thickness also appears to have relationships with brain-substructure volumes.…”

Section: Discussionmentioning

confidence: 99%