1. Articles from steven l. galetta

    1-11 of 11
    1. Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study

      Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study

      Objective To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High‐ and low‐contrast acuity were also collected in a subset ...

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    2. Optimal Inter‐Eye Difference Thresholds by OCT in MS: An International Study

      Optimal Inter‐Eye Difference Thresholds by OCT in MS: An International Study

      Objective To determine the optimal thresholds for inter‐eye differences in retinal nerve fiber and ganglion cell+inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Background Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods In this multi‐center international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High‐ and low‐contrast acuity were also collected ...

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    3. Evolution of Visual Outcomes in Clinical Trials for Multiple Sclerosis Disease-Modifying Therapies

      Evolution of Visual Outcomes in Clinical Trials for Multiple Sclerosis Disease-Modifying Therapies

      rom the Section Editor: In March 2018, the Journal of Neuro-Ophthalmology (JNO) launched its inaugural “Disease of the Year” section, featuring multiple sclerosis (MS). Beginning from a “Bench” perspective, Meltzner and colleagues presented an elegant overview of the pathogenic mechanisms believed to underpin central nervous system (CNS) injury in MS. To complement these efforts, Backner and Levin highlighted how the afferent visual pathway, as a putative model of CNS inflammation, can be interrogated with measures of structure and function to capture clinical and sub-clinical evidence disease activity in MS patients. Building on these concepts in this issue of the JNO ...

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    4. Optical coherence tomography in an optic tract lesion, Retinal nerve fiber layer changes

      Optical coherence tomography in an optic tract lesion, Retinal nerve fiber layer changes

      A 49-year-old woman, status post temporal lobe resection, reported a hemianopia. Examination revealed a right afferent pupillary defect, horizontal bow-tie atrophy OD (temporal and nasal), and temporal atrophy OS. Optical coherence tomography showed a bow-tie pattern OD and predominant superior and inferior nerve fiber layer loss OS (figure 1; figure e-1 at Neurology.org ). The pattern OD is due to the combination of papillomacular bundle and nasal RNFL loss. The pattern OS is due to nerve fiber layer loss temporal to the fovea and, coupled with papillomacular bundle loss, produces temporal pallor. 1 MRI confirmed left optic tract atrophy (figure ...

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    5. Utility of optical coherence tomography in the evaluation of monocular visual loss related to retinal ischemia

      Utility of optical coherence tomography in the evaluation of monocular visual loss related to retinal ischemia

      We report four patients with monocular visual loss for whom optical coherence tomography (OCT) was helpful in distinguishing the sequelae of retinal artery occlusion from those of primary optic neuropathy. Determinations of the peripapillary retinal nerve fiber layer (RNFL) thickness as well as macular retinal layer thicknesses and architecture were used. The major findings in our patients show that changes in the inner retinal layers (including ganglion cell and inner plexiform layer) with disruption of normal macular architecture supports a diagnosis of retinal artery occlusion. Our results support the use of OCT imaging for patients with monocular visual loss of ...

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      Mentions: Laura J. Balcer
    6. Optical Coherence Tomography for the Neurologist

      Optical Coherence Tomography for the Neurologist

      Optical coherence tomography (OCT) is a relatively new technology that is now routinely and very widely used by ophthalmologists for structural documentation of the optic nerve and retina. In neuro-ophthalmology and neurology, the value of OCT is ever expanding; its role in an increasing number of conditions is being reported in parallel with the advances of the technology. Currently, as a clinical tool, OCT is particularly useful for the structural measurement of peripapillary retinal nerve fiber layer thickness, optic nerve head volumetric analysis, and macular anatomy. Optic neuropathies of varied etiology (particularly from multiple sclerosis) may be the most common ...

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      Mentions: Laura J. Balcer
    7. Vision in Multiple Sclerosis: The Story, Structure-Function Correlations, and Models for Neuroprotection

      Vision in Multiple Sclerosis: The Story, Structure-Function Correlations, and Models for Neuroprotection
      Abstract: Visual dysfunction is one of the most common clinical manifestations of multiple sclerosis (MS). Just over a decade ago, MS clincial trials did not include visual outcomes, but experts recognized the need for more sensitive measures of visual function. Low-contrast letter acuity emerged as the leading candidate to measure visual disability in MS, and subsequent studies found low-contrast acuity testing to correlate well with brain MRI lesion burden, visual-evoked potentials, quality of life (QOL), and retinal nerve fiber layer (RNFL) loss, as measured by optical coherence tomography (OCT). OCT in MS has allowed for assessment of structure-function correlations that ...
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    8. Retinal Ganglion Cell Layer Volumetric Assessment by Spectral-Domain Optical Coherence Tomography in Multiple Sclerosis: Application of a High-Precision Manual Estimation Technique

      Retinal Ganglion Cell Layer Volumetric Assessment by Spectral-Domain Optical Coherence Tomography in Multiple Sclerosis: Application of a High-Precision Manual Estimation Technique
      Background: Neuronal loss in the retina has been demonstrated pathologically in eyes of patients with multiple sclerosis (MS). In vivo, MS eyes have reduced total macular volumes by optical coherence tomography (OCT). Using a high-resolution spectral-domain OCT, this pilot study used a manual method to measure ganglion cell layer (GCL) volumes and to determine the relation of these volumes to visual function in MS eyes. Methods: Sixteen eyes of 8 patients with MS and 8 eyes of 5 disease-free control participants were studied using fast macular OCT scans performed with Spectralis OCT (Heidelberg Engineering). Visual function tests of low-contrast letter ...
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    9. Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis

      Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis

      Objective Cross-sectional studies of optical coherence tomography (OCT) show that retinal nerve fiber layer (RNFL) thickness is reduced in multiple sclerosis (MS) and correlates with visual function. We determined how longitudinal changes in RNFL thickness relate to visual loss. We also examined patterns of RNFL thinning over time in MS eyes with and without a prior history of acute optic neuritis (ON). Methods Patients underwent OCT measurement of RNFL thickness at baseline and at 6-month intervals during a mean follow-up of 18 months at 3 centers. Low-contrast letter acuity (2.5%, 1.25% contrast) and visual acuity (VA) were assessed ...

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    10. Macular Volume Determined by Optical Coherence Tomography as a Measure of Neuronal Loss in Multiple Sclerosis

      Macular Volume Determined by Optical Coherence Tomography as a Measure of Neuronal Loss in Multiple Sclerosis

      Background  Inner (area adjacent to the fovea) and outer regions of the macula differ with respect to relative thicknesses of the ganglion cell layer (neurons) vs retinal nerve fiber layer (RNFL; axons).Objective  To determine how inner vs outer macular volumes relate to peripapillary RNFL thickness and visual function in multiple sclerosis (MS) and to examine how these patterns differ among eyes with vs without a history of acute optic neuritis (ON).Design  Study using cross-sectional optical coherence tomography.Setting  Three academic tertiary care MS centers.Participants  Patients with MS, diagnosed by standard criteria, and disease-free control participants.Main Outcome ...

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    11. Retinal Imaging by Laser Polarimetry and Optical Coherence Tomography Evidence of Axonal Degeneration in Multiple Sclerosis

      Background Optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDx) are similar yet provide information on different aspects of retinal nerve fiber layer (RNFL) structure (thickness values similar to histology for OCT vs birefringence of microtubules for GDx). Objectives To compare the ability of OCT and GDx to distinguish eyes of patients with multiple sclerosis (MS) from eyes of disease-free controls and thus identify RNFL abnormalities. We also sought to examine the capacity of these techniques to distinguish MS eyes from those without a history of optic neuritis and to correlate with visual function. Design Cross-sectional ...

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    1-11 of 11
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    Macular Volume Determined by Optical Coherence Tomography as a Measure of Neuronal Loss in Multiple Sclerosis Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis Retinal Ganglion Cell Layer Volumetric Assessment by Spectral-Domain Optical Coherence Tomography in Multiple Sclerosis: Application of a High-Precision Manual Estimation Technique Vision in Multiple Sclerosis: The Story, Structure-Function Correlations, and Models for Neuroprotection Optical Coherence Tomography for the Neurologist Utility of optical coherence tomography in the evaluation of monocular visual loss related to retinal ischemia Optical coherence tomography in an optic tract lesion, Retinal nerve fiber layer changes Evolution of Visual Outcomes in Clinical Trials for Multiple Sclerosis Disease-Modifying Therapies Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study Optical Coherence Tomography Angiography in Myopic Patients Quantification of retinal microvasculature and neurodegeneration changes in branch retinal vein occlusion after resolution of cystoid macular edema on optical coherence tomography angiography Machining head for a laser machining device