Differences in retinal nerve fiber layer atrophy between multiple sclerosis subtypes

J Neurol Sci. 2009 Jun 15;281(1-2):74-9. doi: 10.1016/j.jns.2009.02.354. Epub 2009 Mar 20.


Objectives: To determine whether retinal nerve fiber layer (RNFL) atrophy in the afferent visual pathway may complement existing tools used to describe and characterize differences across MS subtypes.

Methods: Optical coherence tomography-measured RNFL values were compared over two years in 35 patients (70 eyes) with optic neuritis (ON) as a clinically isolated syndrome (CIS); 39 patients (78 eyes) with relapsing remitting MS (RRMS); and 7 patients (14 eyes) with secondary progressive MS (SPMS).

Results: RNFL comparisons involving eyes without ON yielded greater differences between MS subtypes than ON-affected eyes. Overall RNFL values in non-affected eyes were reduced in SPMS patients (83.4 microm), relative to CIS (101.2 microm) (p=0.0009), and RRMS patients (103.7 microm) (p=0.001); and temporal RNFL atrophy was greater in RRMS (64.4 microm) eyes as compared to CIS eyes (73.2 microm) (p=0.02). In ON-affected eyes, RNFL atrophy was greater in SPMS patients (39.5 microm) than CIS patients (58.1 microm) (p=0.03), and in RRMS patients (48.2 microm) relative to CIS patients (p=0.05). RNFL values did not change significantly for any MS subtype during the two-year duration of the study.

Interpretation: RNFL thickness may represent a structural marker, which can help distinguish MS subtypes, because the extent of atrophy is commensurate with disease progression. RNFL comparisons between non-affected eyes revealed greater differences between CIS, RRMS, and SPMS patients relative to ON-affected eyes, because the impact of prior ON may supplant the effects of disease subtype.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Atrophy
  • Female
  • Humans
  • Male
  • Multiple Sclerosis, Chronic Progressive / pathology*
  • Multiple Sclerosis, Relapsing-Remitting / pathology*
  • Nerve Fibers / pathology*
  • Optic Neuritis / pathology*
  • Prospective Studies
  • Retina / pathology*
  • Tomography, Optical Coherence