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

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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., Oberwahrenbrock, T., Metz, I., Zimmermann, H., Pfueller, C.F., Harms, L., Ruprecht, K., Ramien, C., Hahn, K., Brück, W., Niendorf, T., Paul, F., Brandt, A.U., 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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