Optic radiation damage in multiple sclerosis is associated with visual dysfunction and retinal thinning - an ultrahigh-field MR pilot study

Item Type:	Article
Title:	Optic radiation damage in multiple sclerosis is associated with visual dysfunction and retinal thinning - an ultrahigh-field MR pilot study
Creators Name:	Sinnecker, T. and Oberwahrenbrock, T. and Metz, I. and Zimmermann, H. and Pfueller, C.F. and Harms, L. and Ruprecht, K. and Ramien, C. and Hahn, K. and Brück, W. and Niendorf, T. and Paul, F. and Brandt, A.U. and Dörr, J. and Wuerfel, J.
Abstract:	OBJECTIVE: To investigate posterior visual pathway damage in multiple sclerosis using ultrahigh-field magnetic resonance imaging (MRI) at 7 Tesla (7 T), and to determine its correlation with visual disability and retinal fibre layer (RNFL) damage detectable by optic coherence tomography (OCT). METHODS: We studied 7 T MRI, OCT, functional acuity contrast testing (FACT), and visually evoked potentials (VEP, n = 16) in 30 patients (including 26 relapsing-remitting MS and four clinically isolated syndrome patients) and 12 healthy controls to quantify RNFL thickness, optic radiation lesion volume, and optic radiation thickness. RESULTS: Optic radiation lesion volume was associated with thinning of the optic radiation (p < 0.001), delayed VEP (p = 0.031), and visual disability indicated by FACT (p = 0.020). Furthermore, we observed an inverse correlation between optic radiation lesion volume and RNFL thickness (p < 0.001), including patients without previous optic neuritis (p < 0.001). CONCLUSIONS: Anterior visual pathway damage, but also (subclinical) optic radiation integrity loss detectable by 7 T MRI are common findings in MS that are mutually affected. Given the association between optic radiation damage, visual impairment, and increased VEP latency in this exploratory study of a limited sample size, clinicians should be aware of acute lesions within the optic radiation in patients with (bilateral) visual disturbances. KEY POINTS: * Focal destruction of the optic radiation is detectable by 7 T MRI. * Focal optic radiation damage is common in MS. * Optic radiation damage is associated with RNFL thinning, detectable by OCT. * Optic radiation damage is associated with delayed VEP and visual dysfunction. * RNFL thickness in non-optic neuritis eyes correlates with optic radiation demyelination.
Keywords:	Multiple Sclerosis, Magnetic Resonance Imaging, Retinal Nerve Fibre Layer, Optic Radiation, Trans-Synaptic Degeneration
Source:	European Radiology
ISSN:	0938-7994
Publisher:	Springer
Volume:	25
Number:	1
Page Range:	122-131
Date:	January 2015
Official Publication:	https://doi.org/10.1007/s00330-014-3358-8
PubMed:	View item in PubMed

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