PMID- 30999347
OWN - NLM
STAT- MEDLINE
DCOM- 20191016
LR  - 20220408
IS  - 1439-3999 (Electronic)
IS  - 0023-2165 (Linking)
VI  - 236
IP  - 4
DP  - 2019 Apr
TI  - Normal Visual Recovery after Optic Neuritis Despite Significant Loss of Retinal 
      Ganglion Cells in Patients with Multiple Sclerosis.
PG  - 425-428
LID - 10.1055/a-0853-1721 [doi]
AB  - BACKGROUND: Optic neuritis (ON) is a frequent manifestation of demyelinating 
      attack in multiple sclerosis (MS). Initial visual loss can vary from minimal to 
      complete. Visual improvement occurs in about 95% of patients, some of them 
      recovering to normal [visual acuity (VA), color vision, visual field (VF)]. We 
      analyzed retinal ganglion cell layer (RGCL) thickness in MS patients who 
      recovered their normal vision after ON to determine whether a relative 
      preservation of RGCL existed in these patients. MATERIALS AND METHODS: We 
      conducted a retrospective study of all patients with MS and ON examined by one of 
      us (F. X. B.) between 2013 and 2018. Inclusion criteria were strictly unilateral 
      ON, full recovery of vision, computerized visual field, and OCT examinations. 
      Full recovery of vision was defined as VA >/= 10/10, Ishihara >/= 11/13, and VF mean 
      defect (MD) </= 2.6 dB. Evaluation of RGCL was obtained with spectral domain 
      optical coherence tomography (SD-OCT). The normal fellow eye of all patients 
      served as the control group. Relative thinning of RGCL, expressed as percentage, 
      was calculated by comparing results from the affected eye to the fellow eye of 
      the same patient. RESULTS: Twenty-one patients (21 affected eyes - Group 1, 21 
      normal fellow eyes - Group 2) satisfying the inclusion criteria were retrieved 
      from our database. All patients exhibited the relapsing-remitting form of MS. 
      There were 16 women and 5 men. Mean age was 39.3 years old. There were no 
      statistically significant differences between Group 1 and Group 2 for either VA 
      (p = 0.3934) or Ishihara (p = 0.140), but a significant difference was found for 
      VF MD (p = 0.0405). A markedly significant difference for RGCL thickness 
      (p = 0.0001) was found, without any correlation with the degree of visual 
      recovery. A subgroup of patients (n = 14) was examined at the time of initial 
      visual loss. We correlated their results of visual function to the final RGCL 
      thickness, and a correlation was found between either the initial VA loss or the 
      initial VF loss and the final loss of RGCL (R2 = 0.4075 and R2 = 0.00739, 
      respectively). CONCLUSIONS: In our study, all patients with ON lost a significant 
      amount of RGCL despite a full recovery of vision, as defined by our criteria. The 
      percentage of RGCL loss varied from 5 - 27% and could not be correlated with any 
      final visual indices. However, a correlation was found with the degree of initial 
      visual loss. Despite sometimes marked RGCL loss after ON, patients with MS can 
      recover normal visual function, according to standard clinical tests.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Sherif, Mohamed
AU  - Sherif M
AD  - Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, 
      Lausanne, Switzerland.
FAU - Bergin, Ciara
AU  - Bergin C
AD  - Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, 
      Lausanne, Switzerland.
FAU - Borruat, Francois-Xavier
AU  - Borruat FX
AD  - Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, 
      Lausanne, Switzerland.
LA  - eng
PT  - Journal Article
TT  - Wiederherstellung der normalen Sehkraft nach Neuritis nervi optici bei Patienten 
      mit multipler Sklerose trotz signifikantem Verlust von retinalen Ganglienzellen.
DEP - 20190418
PL  - Germany
TA  - Klin Monbl Augenheilkd
JT  - Klinische Monatsblatter fur Augenheilkunde
JID - 0014133
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Male
MH  - *Multiple Sclerosis/complications
MH  - *Optic Neuritis/etiology
MH  - *Retinal Ganglion Cells/pathology
MH  - Retrospective Studies
MH  - Tomography, Optical Coherence
MH  - Visual Field Tests
COIS- The authors declare that they have no conflict of interest.
EDAT- 2019/04/19 06:00
MHDA- 2019/10/17 06:00
CRDT- 2019/04/19 06:00
PHST- 2019/04/19 06:00 [entrez]
PHST- 2019/04/19 06:00 [pubmed]
PHST- 2019/10/17 06:00 [medline]
AID - 10.1055/a-0853-1721 [doi]
PST - ppublish
SO  - Klin Monbl Augenheilkd. 2019 Apr;236(4):425-428. doi: 10.1055/a-0853-1721. Epub 
      2019 Apr 18.