Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: an international study

Item Type:	Article
Title:	Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: an international study
Creators Name:	Nolan, R.C. and Liu, M. and Akhand, O. and Calabresi, P.A. and Paul, F. and Petzold, A. and Balk, L. and Brandt, A.U. and Martínez-Lapiscina, E.H. and Saidha, S. and Villoslada, P. and Abu Al-Hassan, A. and Behbehani, R. and Frohman, E.M. and Frohman, T. and Havla, J. and Hemmer, B. and Jiang, H. and Knier, B. and Korn, T. and Leocani, L. and Papadopoulou, A. and Pisa, M. and Zimmermann, H. and Galetta, S.L. and Balcer, L.J.
Abstract:	OBJECTIVE: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. METHODS: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High‐ and low‐contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. RESULTS: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). INTERPRETATION: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting.
Keywords:	Cohort Studies, Internationality, Multiple Sclerosis, Optic Nerve, Optical Coherence Tomography, Retinal Ganglion Cells, Retinal Neurons, Visual Acuity
Source:	Annals of Neurology
ISSN:	0364-5134
Publisher:	Wiley
Volume:	85
Number:	5
Page Range:	618-629
Date:	May 2019
Additional Information:	Copyright © 2019 American Neurological Association
Official Publication:	https://doi.org/10.1002/ana.25462
External Fulltext:	View full text on external repository or document server
PubMed:	View item in PubMed

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