Axonal loss in non-optic neuritis eyes of patients with multiple sclerosis linked to delayed visual evoked potential

Recent studies demonstrate significant thinning of the retinal nerve fiber layer (RNFL) in multiple sclerosis (MS) non-optic neuritis (MS-NON) eyes. However, the pathologic basis of this reduction is not clear. The aim of the current study was to investigate the relationship of the RNFL thickness in...

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Published in:Neurology Vol. 80; no. 3; p. 242
Main Authors: Klistorner, Alexandr, Garrick, Raymond, Barnett, Michael H, Graham, Stuart L, Arvind, Hemamalini, Sriram, Prema, Yiannikas, Con
Format: Journal Article
Language:English
Published: United States 15.01.2013
Subjects:
Adult
Axons - pathology
Demyelinating Diseases - pathology
Evoked Potentials, Visual
Eye - pathology
Eye - physiopathology
Female
Humans
Male
Middle Aged
Multiple Sclerosis, Chronic Progressive - pathology
Multiple Sclerosis, Chronic Progressive - physiopathology
Neuritis - pathology
Neuritis - physiopathology
Retinal Ganglion Cells - pathology
Retinal Neurons - pathology
Tomography, Optical Coherence
Visual Pathways - pathology
ISSN:1526-632X, 1526-632X
Online Access:Get more information
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Summary:Recent studies demonstrate significant thinning of the retinal nerve fiber layer (RNFL) in multiple sclerosis (MS) non-optic neuritis (MS-NON) eyes. However, the pathologic basis of this reduction is not clear. The aim of the current study was to investigate the relationship of the RNFL thickness in MS-NON eyes with latency delay of the multifocal visual evoked potential (mfVEP), a surrogate marker of the visual pathway demyelination. Total and temporal RNFL thickness and latency of the mfVEP in 45 MS-NON eyes of 45 patients with relapsing-remitting MS and 25 eyes of age- and gender-matched controls were measured and analyzed. There was significant reduction of total and temporal RNFL thickness (p = 0.015 and p = 0.006, respectively) and significant latency delay (p < 0.0001) in MS-NON eyes. Both total and temporal RNFL thickness were associated with latency of the mfVEP (r2 = 0.43, p < 0.0001 and r2 = 0.36, p = 0.001, respectively). MS-NON eyes with normal latency (n = 26) showed no significant reduction of RNFL thickness compared with controls (p = 0.44 and p = 0.1 for total and temporal RNFL, respectively), whereas eyes with delayed latency (n = 19) demonstrated significantly thinner RNFL (p = 0.001 and p = 0.0005). MS-NON eyes with delayed latency also had significantly thinner RNFL compared with those with normal latencies (p = 0.013 and p = 0.02). In patients with no previous optic neuritis in either eye, delayed latency and reduced RNFL were bilateral whenever present. The study demonstrated significant association between RNFL loss and a latency delay of the mfVEP in MS-NON eyes.
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ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0b013e31827deb39