Reduced retinal nerve fiber layer (RNFL) thickness in ALS patients: a window to disease progression

Rohani, Mohammad; Meysamie, Alipasha; Zamani, Babak; Sowlat, M Mahdi; Akhoundi, Fahimeh Haji

doi:10.1007/s00415-018-8863-2

Cited by 39 publications

(63 citation statements)

References 29 publications

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“…Differences found between our study and others in OCT measurements [7,[40][41][42][43]45,52] could be due to the early stages of ALS in our patients. The duration of the disease in our patients (10.80 ± 5.5 months, ranging from 1 to 18 months) was shorter than in other published studies, including [45]. Therefore, classifying these patients according to the duration of the disease is important to obtain a better knowledge of the disease.…”

Section: Discussioncontrasting

confidence: 97%

“…However, in our study comparing ALS baseline vs. ALS follow-up, we found significant thinning, both in MT (inferior IMR and OMR areas) and pRNFL (superior and inferior quadrants and in sectors H3, H5, H6, and H12). Other studies using OCT have also demonstrated a thinning of the MT and pRNFL in these patients [40][41][42][43][44][45]. Volpe et al [42] reported that in ALS patients compared with controls, the total macular volume was significantly thinner and 37.5% of ALS patients had a pRNFL average below the first percentile.…”

Section: Discussionmentioning

confidence: 91%

“…In that study, the histopathological analysis showed a loss of retinal ganglion cell axons, which could explain the macular thinning observed using OCT [42]. Finally, Rohani et al [45] suggested that the thinning of the pRNFL could be related to Wallerian degeneration secondary to the death of cortical neurons. Some studies [62] [16] showed a functional deficit in the sensory processing of the visual pathway to the brain measured by visual evoked potentials (VEPs), both in ALS patients and animal models.…”

Section: Discussionmentioning

confidence: 92%

“…ALS is considered a complex neurodegenerative disease, comprising motor and extra-motor symptoms such as cognitive impairment, behavioral deficits, abnormalities in both brainstem auditory and visual evoked potentials, and subtle visual defects [8,15,16,40,51]. Few studies, especially those using the OCT to determine visual anomalies, relate ALS with the visual system [7,16,[40][41][42][43][44][45][52][53][54][55] because patients do not complain of visual problems, which are overshadowed by motor and respiratory symptoms. In this study, BCVA, VFs, and OCT were analyzed in patients with sporadic ALS and a spinal onset.…”

Section: Discussionmentioning

confidence: 99%

“…Discrepancies among different studies could also be due to: (1) The low number of participant patients, mainly because most of them do not complain of visual problems, and (2) ALS is a heterogeneous disease [41]. However, despite the lack or the low prevalence of visual problems, most studies concluded that these patients underwent retinal changes [40][41][42][43][44][45]52,53].…”

Section: Discussionmentioning

confidence: 99%

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Changes in Retinal OCT and Their Correlations with Neurological Disability in Early ALS Patients, a Follow-Up Study

et al. 2019

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Background: To compare early visual changes in amyotrophic lateral sclerosis (ALS) patients with healthy controls in a baseline exploration, to follow-up the patients after 6 months, and to correlate these visual changes with neurological disability. Methods: All patients underwent a comprehensive neurological and ophthalmological examination. A linear mixed analysis and Bonferroni p-value correction were performed, testing four comparisons as follows: Control baseline vs. control follow-up, control baseline vs. ALS baseline, control follow-up vs. ALS follow-up, and ALS baseline vs. ALS follow-up. Results: The mean time from the diagnosis was 10.80 ± 5.5 months. The analysis of the optical coherence tomography (OCT) showed: (1) In ALS baseline vs. control baseline, a macular significantly increased thickness of the inner macular ring temporal and inferior areas; (2) in ALS follow-up vs. ALS baseline, a significant macular thinning in the inner and outer macular ring inferior areas; (3) in ALS follow-up vs. ALS baseline, a significant peripapillary retinal nerve fiber layer (pRNFL) thinning in the superior and inferior quadrants; and (4) ALS patients showed a moderate correlation between some OCT pRNFL parameters and Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score. Conclusion: The OCT showed retinal changes in patients with motoneuron disease and could serve as a complementary tool for studying ALS.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Changes in Retinal OCT and Their Correlations with Neurological Disability in Early ALS Patients, a Follow-Up Study

et al. 2019

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Amyotrophic lateral sclerosis and retinal changes in optical coherence tomography: A systematic review and meta‐analysis

et al. 2022

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Introduction Increasing evidence suggests Amyotrophic Lateral Sclerosis (ALS) as a widespread pathological process comprising nonmotor features like fatigue, mild sensory symptoms, cognitive decline, and visual impairment. Measurements of retinal nerve fiber layer (RNFL) thickness using Optical Coherence Tomography (OCT) may correlate with the neurodegeneration associated with ALS. In addition to RNFL thickness, other OCT parameters have been explored in the context of diagnosing ALS and predicting disease severity. In this study, we explore the possibility that OCT parameters of patients with ALS may differ significantly from those of healthy controls and thus serve as biomarkers for the disease and its progression. Materials and methods Between 2010 and 2021, the PubMed and EMBASE databases were examined for English language literature. ALS severity was assessed using the revised ALS functional rating scale (ALSFRS‐R). The pooled mean differences in RNFL thickness between ALS patients and controls were calculated using the Standard Mean Difference (Hedges's g) with a 95% confidence interval (CI) in STATA software version 16. Results Eleven studies were reviewed for data collection. RNFL thickness was not statistically significantly different between ALS patients (n = 412) and controls (n = 376) (Hedges's g = –0.22; 95% CI: –0.51 to 0.07, I2 = 73.04%, p = .14). However, the thickness of inner nuclear layer was significantly different between ALS patients and controls (Hedges's g = –0.38; 95% CI: –0.61 to 0.14, I2 = 14.85%, p = .00). Conclusion Our meta‐analysis found that RNFL thickness as a whole or by individual quadrants was not significantly different between ALS patients and controls while the inner nuclear layer (INL) was substantially thinner.

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Retinal OCT biomarkers and neurodegenerative diseases of the central nervous system beyond Alzheimer’s disease

Hopf,

Tüscher,

Schuster

2024

Ophthalmologie

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Reduced retinal nerve fiber layer (RNFL) thickness in ALS patients: a window to disease progression

Cited by 39 publications

References 29 publications

Changes in Retinal OCT and Their Correlations with Neurological Disability in Early ALS Patients, a Follow-Up Study

Changes in Retinal OCT and Their Correlations with Neurological Disability in Early ALS Patients, a Follow-Up Study

Amyotrophic lateral sclerosis and retinal changes in optical coherence tomography: A systematic review and meta‐analysis

Retinal OCT biomarkers and neurodegenerative diseases of the central nervous system beyond Alzheimer’s disease

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