Frequent retinal ganglion cell damage after acute optic neuritis

Item Type:	Article
Title:	Frequent retinal ganglion cell damage after acute optic neuritis
Creators Name:	Brandt, A.U. and Specovius, S. and Oberwahrenbrock, T. and Zimmermann, H.G. and Paul, F. and Costello, F.
Abstract:	Background: To identify the extent of ganglion cell damage after first-time optic neuritis (ON) using the inter-ocular difference between affected and fellow eyes, and whether this approach is able to detect more patients suffering from ganglion cell damage than using absolute values. Methods: Thirty-four patients with first-time unilateral ON were followed for a median 413 days. Patients underwent optical coherence tomography testing to determine ganglion cell plus inner plexiform layer thickness (GCIP). Ganglion cell loss was quantified as GCIP difference between ON-affected and fellow eyes (inter-GCIP) and was compared against measurements from 93 healthy controls (HC). Visual function was assessed with high contrast visual acuity; and standard automated perimetry-derived measures of mean deviation and foveal threshold. Results: At clinical presentation after median 19 days from symptom onset, 47.1% of patients showed early GCIP thinning in the ON-affected eye based on inter-GCIP. At the last visit acute ON was associated with 16.1 ± 10.0 µm GCIP thinning compared to fellow eyes (p = 3.669e-06). Based on inter-GCIP, 84.9% of ON patients sustained GCIP thinning in their affected eye at the last visit, whereas using absolute values only 71.0% of patients suffered from GCIP thinning (p = 0.002076). Only 32.3% of these patients had abnormal visual function. The best predictor of GCIP thinning as a measure of ON severity at the last visit was worse visual field mean deviation at clinical presentation. Conclusion: Inter-ocular GCIP identifies significantly more eyes suffering damage from ON than absolute GCIP, visual fields or visual acuity loss. Effective interventional options are needed to prevent ganglion cell loss.
Keywords:	Optic Neuritis, Optical Coherence Tomography, Multiple Sclerosis, Vision
Source:	Multiple Sclerosis and Related Disorders
ISSN:	2211-0348
Publisher:	Elsevier
Volume:	22
Page Range:	141-147
Date:	May 2018
Official Publication:	https://doi.org/10.1016/j.msard.2018.04.006
PubMed:	View item in PubMed

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