Retinal nerve fibre layer measurements and optic nerve head analysis in multiple sclerosis patients

Abstract

Purpose To verify whether scanning laser polarimeter with the new variable corneal compensation algorithm (GDx VCC) and scanning laser ophthalmoscopy (Heidelberg Retina Tomograph (HRT)) allow measuring retinal ganglion cell loss in patients with multiple sclerosis (MS). Patients and methods We enrolled 23 MS patients with a history of previous demyelinating monocular optic neuritis. Examination included visual evoked potentials (VEPs), scanning laser ophthalmoscopy, and scanning laser polarimeter. HRT was performed to assess optic nerve head (ONH) shape, while GDx VCC was used to evaluate the retinal nerve fibre layer thickness (RNFLt) around the ONH. Statistical analysis was performed comparing results obtained for each eye with the available normative database and with the unaffected fellow eye. Results When the affected eye group was compared to the fellow-eye group, a significant (Po0.05) difference was found for few GDx VCC parameters. In contrast, no significant correlation was observed between clinical assessment and imaging techniques when the normal database of HRT and GDx VCC was used. A significant association was observed between VEP latency and some GDx VCC parameters. Conclusions Our results suggested that scanning laser polarimetry could detect loss of ganglion cells following demyelinating optic neuritis, but further studies are needed.

Relationship between Structural and Functional Assessment of the Visual System in Mildly Disabled Relapsing-Remitting Multiple Sclerosis Patients

“…25 Also, some studies found increased P100 latency in MS eyes: not only in patients with ON, but also in those without a history of previous ON. 10,11,[26][27][28] In our study, we found significant prolonged P100 latency similar to the results of the above studies. Most of the previous studies have demonstrated a decrease in P100 wave amplitudes in MS eyes compared with controls.…”

“…The usefulness of VEP for evaluation of abnormalities in the anterior visual pathway in MS patients has been reported in several previous studies dating back several years. 10,11,[25][26][27][28] Weinstock-Guttman et al evaluated 37 MS patients and found prolonged P100 latency in 75% of them. 25 Also, some studies found increased P100 latency in MS eyes: not only in patients with ON, but also in those without a history of previous ON.…”

“…27 Iester et al enrolled the optic nerve head shape in 23 MS patients with a history of ON using scanning laser ophthalmoscopy; they did not find significant differences on ONH parameters between MS eyes with ON and an available normative database, and between MS eyes with ON and the unaffected fellow eye. 27 Although these results support ours with respect to unaltered optic nerve values, future research may be required to clarify the changes in ONH in MS.…”

Sub‐clinical atrophy of the retinal nerve fibre layer in multiple sclerosis

“…However, in a recent study, Iester et al (2007) reported that GDx is able to detect loss of ganglion cells following demyelinating optic neuritis in MS patients and that, as we observed, there is good correlation between VEP abnormalities and some GDx parameters.…”

Retinal nerve fiber layer thickness changes following optic neuritis caused by multiple sclerosis

“…1-3 RNFL loss is not specifi c to glaucoma. Recent literature reports indicate that the GDx VCC demonstrates decreases in RNFL thickness in patients with optic neuritis (ON), [4][5][6] but that visual evoked potential (VEP) or static perimetry is superior to the GDx VCC in detecting early damage of ON in patients with multiple sclerosis (MS). 7 This study evaluated the structural changes in peripapillary RNFL using the GDx VCC in patients with ON resulting from MS and compared them with those of healthy subjects.…”