PMID- 28192539
OWN - NLM
STAT- MEDLINE
DCOM- 20170829
LR  - 20220311
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 2
DP  - 2017
TI  - Optical coherence tomography segmentation analysis in relapsing remitting versus 
      progressive multiple sclerosis.
PG  - e0172120
LID - 10.1371/journal.pone.0172120 [doi]
LID - e0172120
AB  - INTRODUCTION: Optical coherence tomography (OCT) with retinal segmentation 
      analysis is a valuable tool in assessing axonal loss and neuro-degeneration in 
      multiple sclerosis (MS) by in-vivo imaging, delineation and quantification of 
      retinal layers. There is evidence of deep retinal involvement in MS beyond the 
      inner retinal layers. The ultra-structural retinal changes in MS in different MS 
      phenotypes can reflect differences in the pathophysiologic mechanisms. There is 
      limited data on the pattern of deeper retinal layer involvement in progressive MS 
      (PMS) versus relapsing remitting MS (RRMS). We have compared the OCT segmentation 
      analysis in patients with relapsing-remitting MS and progressive MS. METHODS: 
      Cross-sectional study of 113 MS patients (226 eyes) (29 PMS, 84 RRMS) and 38 
      healthy controls (72 eyes). Spectral domain OCT (SDOCT) using the macular cube 
      acquisition protocol (Cirrus HDOCT 5000; Carl Zeiss Meditec) and segmentation of 
      the retinal layers for quantifying the thicknesses of the retinal layers. 
      Segmentation of the retinal layers was carried out utilizing Orion software 
      (Voxeleron, USA) for quantifying the thicknesses of individual retinal layers. 
      RESULTS: The retinal nerve finer layer (RNFL) (p = 0.023), the 
      ganglion-cell/inner plexiform layer (GCIPL) (p = 0.006) and the outer plexiform 
      layer (OPL) (p = 0.033) were significantly thinner in PMS compared to RRMS. There 
      was significant negative correlation between the outer nuclear layer (ONL) and 
      EDSS (r = -0.554, p = 0.02) in PMS patients. In RRMS patients with prior optic 
      neuritis, the GCIPL correlated negatively (r = -0.317; p = 0.046), while the 
      photoreceptor layer (PR) correlated positively with EDSS (r = 0.478; p = 0.003). 
      CONCLUSIONS: Patients with PMS exhibit more atrophy of both the inner and outer 
      retinal layers than RRMS. The ONL in PMS and the GCIPL and PR in RRMS can serve 
      as potential surrogate of disease burden and progression (EDSS). The specific 
      retinal layer predilection and its correlation with disability may reflect 
      different pathophysiologic mechanisms and various stages of progression in MS.
FAU - Behbehani, Raed
AU  - Behbehani R
AD  - Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait City, Kuwait.
AD  - Neurology Clinic, Dasman Institute, Dasman, Kuwait.
FAU - Abu Al-Hassan, Abdullah
AU  - Abu Al-Hassan A
AD  - Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait City, Kuwait.
FAU - Al-Salahat, Ali
AU  - Al-Salahat A
AD  - Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait City, Kuwait.
FAU - Sriraman, Devarajan
AU  - Sriraman D
AD  - National Dasman Diabetes Biobank, Dasman Institute, Dasman, Kuwait.
FAU - Oakley, J D
AU  - Oakley JD
AD  - Voxeleron LLC, Pleasanton, CA, United States of America.
FAU - Alroughani, Raed
AU  - Alroughani R
AD  - Neurology Clinic, Dasman Institute, Dasman, Kuwait.
AD  - Division of Neurology, Amiri Hospital, Sharq, Kuwait.
LA  - eng
PT  - Journal Article
DEP - 20170213
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Atrophy/diagnostic imaging/physiopathology
MH  - Cross-Sectional Studies
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/*diagnostic imaging/physiopathology
MH  - Multiple Sclerosis, Relapsing-Remitting/*diagnostic imaging/physiopathology
MH  - Optic Neuritis/diagnostic imaging/physiopathology
MH  - Reproducibility of Results
MH  - Retina/*diagnostic imaging/pathology/physiopathology
MH  - Retinal Ganglion Cells/pathology
MH  - Tomography, Optical Coherence/*methods
MH  - Young Adult
PMC - PMC5305239
COIS- Jonathan Oakley is an employee of Voxeleron LLC who created the OCT analysis 
      software used in the study. The software found on the host device, the Cirrus, is 
      not able to perform the segmentations required of this study. The data exported 
      from the Cirrus devices was in Dicom format that required conversion to raw data 
      for processing in Orion. Dr. Oakley performed all of the necessary conversion.
EDAT- 2017/02/14 06:00
MHDA- 2017/08/30 06:00
PMCR- 2017/02/13
CRDT- 2017/02/14 06:00
PHST- 2016/06/19 00:00 [received]
PHST- 2017/01/31 00:00 [accepted]
PHST- 2017/02/14 06:00 [entrez]
PHST- 2017/02/14 06:00 [pubmed]
PHST- 2017/08/30 06:00 [medline]
PHST- 2017/02/13 00:00 [pmc-release]
AID - PONE-D-16-24570 [pii]
AID - 10.1371/journal.pone.0172120 [doi]
PST - epublish
SO  - PLoS One. 2017 Feb 13;12(2):e0172120. doi: 10.1371/journal.pone.0172120. 
      eCollection 2017.