Degeneration of retinal layers in multiple sclerosis subtypes quantified by optical coherence tomography

• Published in: Multiple sclerosis Vol. 18; no. 10; pp. 1422 - 1429
• Main Authors: Albrecht, P, Ringelstein, M, Müller, AK, Keser, N, Dietlein, T, Lappas, A, Foerster, A, Hartung, HP, Aktas, O, Methner, A
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2012; Sage Publications; Sage Publications Ltd
• Subjects: Adult; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Humans; Male; Medical sciences; Middle Aged; Multiple Sclerosis - complications; Multiple Sclerosis - pathology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Retina - pathology; Tomography, Optical Coherence; optical coherence tomography; retina; optical neuritis; multiple sclerosis; primary progressive multiple sclerosis; retinal layers; retinal ganglion; Nervous system diseases; Multiple sclerosis; Retinopathy; Optical coherence tomography; Multiple layer; Retina; Nevritis; Inflammatory disease; Eye; Macular degeneration; Visual system; Eye disease; Central nervous system disease; Degenerative disease; Subtype
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458512439237

Background: Optical coherence tomography can be used to assess retinal degeneration in multiple sclerosis (MS). Thinning of the retinal nerve fibre layer and macular thickness have been well characterized, but newer devices allow quantification of all retinal layers. Objectives: The objective of this study was to evaluate the thickness of the paramacular retina, peripapillary retinal nerve fibre layer, and deeper paramacular layers in MS patient subgroups, using state-of-the-art optical coherence tomography. Methods: Using a Heidelberg Engineering Spectralis device, we performed paramacular volumetric retinal scans and circular peripapillary fibre-layer scans, manually segmenting different retinal layers into single horizontal foveal scans in 95 patients with definite MS (42 relapsing–remitting, 41 secondary progressive, 12 primary progressive), plus 91 age- and sex-matched controls. Results: Even without a history of optic neuritis, all MS subgroups had significant thinning of the peripapillary retinal nerve fibre layer, the paramacular retinal thickness and the retinal ganglion cell- and inner plexiform layer. Only in primary progressive MS was the inner nuclear layer significantly reduced. Conclusions: Our findings indicate a primary retinal pathology involving the inner nuclear layer in primary progressive MS. Results in eyes without history of optic neuritis suggest possible subclinical episodes of optic neuritis or retrograde trans-synaptic degeneration of retinal ganglion cells and their axons.