Frequent retinal ganglion cell damage after acute optic neuritis

Mult Scler Relat Disord. 2018 May;22:141-147. doi: 10.1016/j.msard.2018.04.006. Epub 2018 Apr 9.

Abstract

Background: To identify the extent of ganglion cell damage after first-time optic neuritis (ON) using the inter-ocular difference between affected and fellow eyes, and whether this approach is able to detect more patients suffering from ganglion cell damage than using absolute values.

Methods: Thirty-four patients with first-time unilateral ON were followed for a median 413 days. Patients underwent optical coherence tomography testing to determine ganglion cell plus inner plexiform layer thickness (GCIP). Ganglion cell loss was quantified as GCIP difference between ON-affected and fellow eyes (inter-GCIP) and was compared against measurements from 93 healthy controls (HC). Visual function was assessed with high contrast visual acuity; and standard automated perimetry-derived measures of mean deviation and foveal threshold.

Results: At clinical presentation after median 19 days from symptom onset, 47.1% of patients showed early GCIP thinning in the ON-affected eye based on inter-GCIP. At the last visit acute ON was associated with 16.1 ± 10.0 µm GCIP thinning compared to fellow eyes (p = 3.669e-06). Based on inter-GCIP, 84.9% of ON patients sustained GCIP thinning in their affected eye at the last visit, whereas using absolute values only 71.0% of patients suffered from GCIP thinning (p = 0.002076). Only 32.3% of these patients had abnormal visual function. The best predictor of GCIP thinning as a measure of ON severity at the last visit was worse visual field mean deviation at clinical presentation.

Conclusion: Inter-ocular GCIP identifies significantly more eyes suffering damage from ON than absolute GCIP, visual fields or visual acuity loss. Effective interventional options are needed to prevent ganglion cell loss.

Keywords: Multiple sclerosis; Optic neuritis; Optical coherence tomography; Vision.

MeSH terms

  • Adult
  • Cell Death
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Multivariate Analysis
  • Optic Neuritis / diagnostic imaging*
  • Optic Neuritis / pathology*
  • Organ Size
  • Prognosis
  • Retinal Ganglion Cells / pathology*
  • Tomography, Optical Coherence
  • Visual Acuity