PMID- 22365058
OWN - NLM
STAT- MEDLINE
DCOM- 20120822
LR  - 20220409
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Print)
IS  - 0161-6420 (Linking)
VI  - 119
IP  - 6
DP  - 2012 Jun
TI  - Ganglion cell loss in relation to visual disability in multiple sclerosis.
PG  - 1250-7
LID - 10.1016/j.ophtha.2011.11.032 [doi]
AB  - PURPOSE: We used high-resolution spectral-domain optical coherence tomography 
      (SD-OCT) with retinal segmentation to determine how ganglion cell loss relates to 
      history of acute optic neuritis (ON), retinal nerve fiber layer (RNFL) thinning, 
      visual function, and vision-related quality of life (QOL) in multiple sclerosis 
      (MS). DESIGN: Cross-sectional study. PARTICIPANTS: A convenience sample of 
      patients with MS (n = 122; 239 eyes) and disease-free controls (n = 31; 61 eyes). 
      Among MS eyes, 87 had a history of ON before enrollment. METHODS: The SD-OCT 
      images were captured using Macular Cube (200x200 or 512x128) and ONH Cube 200x200 
      protocols. Retinal layer segmentation was performed using algorithms established 
      for glaucoma studies. Thicknesses of the ganglion cell layer/inner plexiform 
      layer (GCL+IPL), RNFL, outer plexiform/inner nuclear layers (OPL+INL), and outer 
      nuclear/photoreceptor layers (ONL+PRL) were measured and compared in MS versus 
      control eyes and MS ON versus non-ON eyes. The relation between changes in 
      macular thickness and visual disability was also examined. MAIN OUTCOME MEASURES: 
      The OCT measurements of GCL+IPL and RNFL thickness; high contrast visual acuity 
      (VA); low-contrast letter acuity (LCLA) at 2.5% and 1.25% contrast; on the 
      25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and 
      10-Item Neuro-Ophthalmic Supplement composite score. RESULTS: Macular RNFL and 
      GCL+IPL were significantly decreased in MS versus control eyes (P<0.001 and P = 
      0.001) and in MS ON versus non-ON eyes (P<0.001 for both measures). Peripapillary 
      RNFL, macular RNFL, GCL+IPL, and the combination of macular RNFL+GCL+IPL were 
      significantly correlated with VA (P</=0.001), 2.5% LCLA (P<0.001), and 1.25% LCLA 
      (P</=0.001). Among OCT measurements, reductions in GCL+IPL (P<0.001), macular RNFL 
      (P = 0.006), and the combination (macular RNFL+GCL+IPL; P<0.001) were most 
      strongly associated with lower (worse) NEI-VFQ-25 and 10-Item Supplement QOL 
      scores; GCL+IPL thinning was significant even accounting for macular RNFL 
      thickness (P = 0.03 for GCL+IPL, P = 0.39 for macular RNFL). CONCLUSIONS: We 
      demonstrated that GCL+IPL thinning is most significantly correlated with both 
      visual function and vision-specific QOL in MS, and may serve as a useful 
      structural marker of disease. Our findings parallel those of magnetic resonance 
      imaging studies that show gray matter disease is a marker of neurologic 
      disability in MS. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure 
      may be found after the references.
CI  - Copyright (c) 2012 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Walter, Scott D
AU  - Walter SD
AD  - Department of Neurology, University of Pennsylvania School of Medicine, 
      Philadelphia, Pennsylvania, USA.
FAU - Ishikawa, Hiroshi
AU  - Ishikawa H
FAU - Galetta, Kristin M
AU  - Galetta KM
FAU - Sakai, Reiko E
AU  - Sakai RE
FAU - Feller, Daniel J
AU  - Feller DJ
FAU - Henderson, Sam B
AU  - Henderson SB
FAU - Wilson, James A
AU  - Wilson JA
FAU - Maguire, Maureen G
AU  - Maguire MG
FAU - Galetta, Steven L
AU  - Galetta SL
FAU - Frohman, Elliot
AU  - Frohman E
FAU - Calabresi, Peter A
AU  - Calabresi PA
FAU - Schuman, Joel S
AU  - Schuman JS
FAU - Balcer, Laura J
AU  - Balcer LJ
LA  - eng
GR  - R01 EY 014993/EY/NEI NIH HHS/United States
GR  - K24 EY 018136/EY/NEI NIH HHS/United States
GR  - R01 EY013178/EY/NEI NIH HHS/United States
GR  - K24 EY018136/EY/NEI NIH HHS/United States
GR  - R01 EY014993/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20120223
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
CIN - Ophthalmology. 2013 Feb;120(2):440-1. PMID: 23374583
MH  - Adult
MH  - Algorithms
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/*physiopathology
MH  - Nerve Fibers/*pathology
MH  - Optic Neuritis/*physiopathology
MH  - *Quality of Life
MH  - Retinal Ganglion Cells/*pathology
MH  - Sickness Impact Profile
MH  - Surveys and Questionnaires
MH  - Tomography, Optical Coherence
MH  - Vision Disorders/physiopathology
MH  - Visual Acuity/*physiology
PMC - PMC3631566
MID - NIHMS340639
EDAT- 2012/03/01 06:00
MHDA- 2012/08/23 06:00
PMCR- 2013/06/01
CRDT- 2012/02/28 06:00
PHST- 2011/08/15 00:00 [received]
PHST- 2011/11/04 00:00 [revised]
PHST- 2011/11/22 00:00 [accepted]
PHST- 2012/02/28 06:00 [entrez]
PHST- 2012/03/01 06:00 [pubmed]
PHST- 2012/08/23 06:00 [medline]
PHST- 2013/06/01 00:00 [pmc-release]
AID - S0161-6420(11)01135-3 [pii]
AID - 10.1016/j.ophtha.2011.11.032 [doi]
PST - ppublish
SO  - Ophthalmology. 2012 Jun;119(6):1250-7. doi: 10.1016/j.ophtha.2011.11.032. Epub 
      2012 Feb 23.