Inner Nuclear Layer Thickening Is Inversley Proportional to Retinal Ganglion Cell Loss in Optic Neuritis

To examine the relationship between retinal ganglion cell loss and changes in the inner nuclear layer (INL) in optic neuritis (ON). 36 multiple sclerosis (MS) patients with a history of ON and 36 age and sex-matched controls underwent Optical Coherence Tomography. The paramacular retinal nerve fiber...

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Veröffentlicht in:PloS one Jg. 8; H. 10; S. e78341
Hauptverfasser: Kaushik, Megha, Wang, Chen Yu, Barnett, Michael H., Garrick, Raymond, Parratt, John, Graham, Stuart L., Sriram, Prema, Yiannikas, Con, Klistorner, Alexandr
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 03.10.2013
Public Library of Science (PLoS)
Schlagworte:
Adult
Analysis
Brain research
Case-Control Studies
Cell Count
Correlation
Edema
Enlargement
Eye
Female
Fovea
Ganglion cysts
Hospitals
Humans
Macular degeneration
Male
Microcysts
Middle Aged
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - diagnosis
Multiple Sclerosis - pathology
Neuritis
Neurology
Optic neuritis
Optic Neuritis - complications
Optic Neuritis - diagnosis
Optic Neuritis - pathology
Optical Coherence Tomography
Optics
Patients
Retina
Retinal Ganglion Cells - pathology
Retinal Neurons - pathology
Severity of Illness Index
Studies
Systematic review
Thickening
Thickness
Tomography
Tomography, Optical Coherence
Variability
Australia
New South Wales Australia
ISSN:1932-6203, 1932-6203
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Zusammenfassung:To examine the relationship between retinal ganglion cell loss and changes in the inner nuclear layer (INL) in optic neuritis (ON). 36 multiple sclerosis (MS) patients with a history of ON and 36 age and sex-matched controls underwent Optical Coherence Tomography. The paramacular retinal nerve fiber layer (RNFL), combined ganglion cell and inner plexiform layers (GCL/IPL) and inner nuclear layer (INL) thickness were measured at 36 points around the fovea. To remove inter-subject variability, the difference in thickness of each layer between the ON and fellow eye of each patient was calculated. A topographic analysis was conducted. The INL of the ON patients was thicker than the controls (42.9µm versus 39.6µm, p=0.002). ON patients also had a thinner RNFL (27.8µm versus 32.2µm, p<0.001) and GCL/IPL (69.3µm versus 98.1µm, p<0.001). Among the controls, there was no correlation between RNFL and GCL/IPL as well as RNFL and INL, but a positive correlation was seen between GCL/IPL and INL (r=0.65, p<0.001). In the ON group, there was a positive correlation between RNFL and GCL/IPL (r=0.80, p<0.001) but a negative correlation between RNFL and INL (r=-0.61, p<0.001) as well as GCL/IPL and INL (r=-0.44, p=0.007). The negative correlation between GCL/IPL and INL strengthened in the ON group when inter-subject variability was removed (r=-0.75, p<0.001). Microcysts within the INL were present in 5 ON patients, mainly in the superior and infero-nasal paramacular regions. While patients with microcysts lay at the far end of the correlation curve between GCL/IPL and INL (i.e. larger INL and smaller GCL/IPL compared to other patients), their exclusion did not affect the correlation (r= -0.76, p<0.001). INL enlargement in MS-related ON is associated with the severity of GCL loss. This is a continuous relationship and patients with INL microcysts may represent the extreme end of the scale.
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Conceived and designed the experiments: AK. Performed the experiments: MK AK CYW PS. Analyzed the data: MK AK SG MHB RG JP CY. Contributed reagents/materials/analysis tools: AK. Wrote the manuscript: MK AK.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0078341