1. Articles from Friedemann Paul

    1-26 of 26
    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. Novel uses of retinal imaging with optical coherence tomography in multiple sclerosis

      Novel uses of retinal imaging with optical coherence tomography in multiple sclerosis

      Introduction : Multiple Sclerosis (MS) is the most common chronic autoimmune neuroinflammatory condition in young adults. It is often accompanied by optic neuritis (ON) and retinal neuro-axonal damage causing visual disturbances. Optical coherence tomography (OCT) is a sensitive non-invasive method for quantifying intraretinal layer volumes. Recently, OCT not only showed to be a reliable marker for ON-associated damage, but also proved its high prognostic value for functional outcome and disability accrual in patients with MS. Consequently, OCT is discussed as a potential marker for monitoring disease severity and therapeutic response in individual patients. Areas covered : This article summarizes our current understanding ...

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      Mentions: Friedemann Paul
    4. Optical Coherence Tomography in Disorders of the Central Nervous System

      Optical Coherence Tomography in Disorders of the Central Nervous System

      Retinal changes and visual symptoms are present in several inflammatory, degenerative and tumorous disorders of the central nervous system (CNS). Optical coherence tomography (OCT) is a method that can be used in clinical practice to detect and quantify the structural correlates of these visual symptoms in neurological disorders. OCT is a non-invasive imaging technique, based on interferometry, which can create high-resolution images of the retina and measure the thickness and volume of the different retinal layers. The combined ganglion cell- and inner plexiform layer (GCIPL) and the peripapillary retinal nerve fibre layer (pRNFL) are of particular interest in the field ...

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    5. The International Multiple Sclerosis Visual System Consortium: Advancing Visual System Research in Multiple Sclerosis

      The International Multiple Sclerosis Visual System Consortium: Advancing Visual System Research in Multiple Sclerosis

      Background: The International Multiple Sclerosis Visual System Consortium (IMSVISUAL) was formed in November 2014 with the primary goal of improving research, care, and education regarding the role of the visual system in multiple sclerosis (MS) and related disorders. Methods: In this review, we describe the formation, goals, activities, and structure of IMSVISUAL, as well as the relationship of IMSVISUAL with the Americas Committee for Treatment and Research in MS (ACTRIMS). Finally, we provide an overview of the work IMSVISUAL has completed to date, as well as an outline of research projects ongoing under the auspices of IMSVISUAL. Results: IMSVISUAL has ...

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    6. Optical coherence tomography in acute optic neuritis: A population‐based study

      Optical coherence tomography in acute optic neuritis: A population‐based study

      Objectives To measure early structural damage caused by autoimmune inflammatory optic neuritis (ON) by optical coherence tomography (OCT) in a population‐based cohort. Methods In a prospective population‐based study over 24 months in Southern Denmark, patients diagnosed with acute ON and without prior diagnosis of a chronic neuroinflammatory disorder were included and examined with OCT, visual evoked potentials (VEP), visual fields, high contrast visual acuity (HCVA), and low contrast letter acuity (LCLA). Structural and functional outcomes were determined at 6‐month follow‐up based on interocular differences. Results The 50 included patients had on average 16.9 μm peripapillary ...

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    7. Multicenter reliability of semiautomatic retinal layer segmentation using OCT

      Multicenter reliability of semiautomatic retinal layer segmentation using OCT

      Objective To evaluate the inter-rater reliability of semiautomated segmentation of spectral domain optical coherence tomography (OCT) macular volume scans. Methods Macular OCT volume scans of left eyes from 17 subjects (8 patients with MS and 9 healthy controls) were automatically segmented by Heidelberg Eye Explorer (v1.9.3.0) beta-software (Spectralis Viewing Module v6.0.0.7), followed by manual correction by 5 experienced operators from 5 different academic centers. The mean thicknesses within a 6-mm area around the fovea were computed for the retinal nerve fiber layer, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer ...

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    8. Optical coherence tomography in neuromyelitis optica spectrum disorders: potential advantages for individualized monitoring of progression and therapy

      Optical coherence tomography in neuromyelitis optica spectrum disorders: potential advantages for individualized monitoring of progression and therapy

      Neuromyelitis optica spectrum disorders (NMOSD) are mostly relapsing inflammatory disorders of the central nervous system (CNS). Optic neuritis (ON) is the first NMOSD-related clinical event in 55% of the patients, which causes damage to the optic nerve and leads to visual impairment. Retinal optical coherence tomography (OCT) has emerged as a promising method for diagnosis of NMOSD and potential individual monitoring of disease course and severity. OCT not only detects damage to the afferent visual system caused by ON but potentially also NMOSD-specific intraretinal pathology, i.e. astrocytopathy. This article summarizes retinal involvement in NMOSD and reviews OCT methods that ...

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      Mentions: Friedemann Paul
    9. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Background Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. Methods In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis, and progressive multiple sclerosis. Patients were recruited from centres in Spain, Italy, France, Germany ...

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    10. The APOSTEL recommendations for reporting quantitative optical coherence tomography studies

      The APOSTEL recommendations for reporting quantitative optical coherence tomography studies

      Objective: To develop consensus recommendations for reporting of quantitative optical coherence tomography (OCT) study results. Methods: A panel of experienced OCT researchers (including 11 neurologists, 2 ophthalmologists, and 2 neuroscientists) discussed requirements for performing and reporting quantitative analyses of retinal morphology and developed a list of initial recommendations based on experience and previous studies. The list of recommendations was subsequently revised during several meetings of the coordinating group. Results: We provide a 9-point checklist encompassing aspects deemed relevant when reporting quantitative OCT studies. The areas covered are study protocol, acquisition device, acquisition settings, scanning protocol, funduscopic imaging, postacquisition data selection ...

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    11. Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study

      Background Most patients with multiple sclerosis without previous optic neuritis have thinner retinal layers than healthy controls. We assessed the role of peripapillary retinal nerve fibre layer (pRNFL) thickness and macular volume in eyes with no history of optic neuritis as a biomarker of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. Methods In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis, and progressive multiple sclerosis. Patients were recruited from centres in Spain, Italy, France, Germany ...

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    12. Retinal pathology in Susac syndrome detected by spectral-domain optical coherence tomography

      Retinal pathology in Susac syndrome detected by spectral-domain optical coherence tomography

      Objective: The aim of this non-interventional study was to characterize retinal layer pathology in Susac syndrome (SuS), a disease with presumably autoimmune-mediated microvessel occlusions in the retina, brain, and inner ear, in comparison to the most important differential diagnosis multiple sclerosis (MS). Methods: Seventeen patients with SuS and 17 age- and sex-matched patients with relapsing-remitting MS (RRMS) and healthy controls (HC) were prospectively investigated by spectral-domain optical coherence tomography (OCT) including intraretinal layer segmentation in a multicenter study. Patients with SuS additionally received retinal fluorescein angiography (FA) and automated perimetry. Results: Patchy thinning of the retinal nerve fiber layer, ganglion ...

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    13. Retinal pathology in idiopathic moyamoya angiopathy detected by optical coherence tomography

      Retinal pathology in idiopathic moyamoya angiopathy detected by optical coherence tomography

      Objective: To investigate whether patients with moyamoya angiopathy without obvious retinal pathologies such as retinal infarctions or the congenital morning glory anomaly may have subtle subclinical retinal changes. Methods: In this cross-sectional study, spectral domain optical coherence tomography was used to analyze the retinal morphology of 25 patients with idiopathic moyamoya angiopathy and 25 age- and sex-matched healthy controls. We analyzed the retinal vasculature with blue laser autofluorescence, lipofuscin deposits with MultiColor confocal scanning laser ophthalmoscopy, and the optic nerve head (ONH) volume with a custom postprocessing algorithm. In addition to the total retinal thickness, semiautomated segmentation was used for ...

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      Mentions: Friedemann Paul
    14. Temporal retinal nerve fibre layer thinning in cluster headache patients detected by optical coherence tomography

      Temporal retinal nerve fibre layer thinning in cluster headache patients detected by optical coherence tomography

      Background The exact pathophysiology of cluster headache (CH) is still not fully clarified. Various studies confirmed changes in ocular blood flow during CH attacks. Furthermore, vasoconstricting medication influences blood supply to the eye. We investigated the retina of CH patients for structural retinal alterations with optical coherence tomography (OCT), and how these changes correlate to headache characteristics, oxygen use and impaired visual function. Methods Spectral domain OCT of 107 CH patients – 67 episodic, 35 chronic, five former chronic sufferers – were compared to OCT from 65 healthy individuals. Visual function tests with Sloan charts and a substantial ophthalmologic examination were engaged ...

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    15. Optical coherence tomography for retinal imaging in multiple sclerosis

      Optical coherence tomography for retinal imaging in multiple sclerosis

      Visual disturbances caused by inflammatory and demyelinating processes of the visual system, mainly in the optic nerve, are a common symptom in multiple sclerosis (MS). Optical coherence tomography (OCT) is a tool that is increasingly used for quantifying retinal damage in MS and other neurologic diseases. Based on spectral interferometry, it uses low-coherent infrared light to generate high-resolution spatial images of the retina. The retinal nerve fiber layer (RNFL) consists of unmyelinated axons that form the optic nerve, and thus represents a part of the central nervous system. OCT allows for noninvasive measurements of RNFL thickness in micrometer resolution. With ...

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    16. Vessel Labeling in Combined Confocal Scanning Laser Ophthalmoscopy and Optical Coherence Tomography Images: Criteria for Blood Vessel Discrimination

      Vessel Labeling in Combined Confocal Scanning Laser Ophthalmoscopy and Optical Coherence Tomography Images: Criteria for Blood Vessel Discrimination

      Introduction The diagnostic potential of optical coherence tomography (OCT) in neurological diseases is intensively discussed. Besides the sectional view of the retina, modern OCT scanners produce a simultaneous top-view confocal scanning laser ophthalmoscopy (cSLO) image including the option to evaluate retinal vessels. A correct discrimination between arteries and veins (labeling) is vital for detecting vascular differences between healthy subjects and patients. Up to now, criteria for labeling (cSLO) images generated by OCT scanners do not exist. Objective This study reviewed labeling criteria originally developed for color fundus photography (CFP) images. Methods The criteria were modified to reflect the cSLO technique ...

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    17. The investigation of acute optic neuritis: a review and proposed protocol

      The investigation of acute optic neuritis: a review and proposed protocol

      Optic neuritis is an inflammatory optic neuropathy that affects many patients with multiple sclerosis (MS) at some point during their disease course. Differentiation of acute episodes of MS-associated optic neuritis from other autoimmune and inflammatory optic neuropathies is vital for treatment choice and further patient management, but is not always straightforward. Over the past decade, a number of new imaging, laboratory and electrophysiological techniques have entered the clinical arena. To date, however, no consensus guidelines have been devised to specify how and when these techniques can be most rationally applied for the diagnostic work-up of patients with acute optic neuritis ...

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    18. Retinal nerve fibre layer thickness correlates with brain white matter damage in multiple sclerosis: A combined optical coherence tomography and diffusion tensor imaging study

      Retinal nerve fibre layer thickness correlates with brain white matter damage in multiple sclerosis: A combined optical coherence tomography and diffusion tensor imaging study

      We investigated the association of retinal nerve fibre layer thickness (RNFL) with white matter damage assessed by diffusion tensor imaging (DTI). Forty-four MS patients and 30 healthy subjects underwent optical coherence tomography. DTI was analysed with a voxel-based whole brain and region-based analysis of optic radiation, corpus callosum and further white matter. Correlations between RNFL, fractional anisotropy (FA) and other DTI-based parameters were assessed in patients and controls. RNFL correlated with optic radiation FA, but also with corpus callosum and remaining white matter FA. Our findings demonstrate that RNFL changes indicate white matter damage exceeding the visual pathway.

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    19. Optical Coherence Tomography Reveals Distinct Patterns of Retinal Damage in Neuromyelitis Optica and Multiple Sclerosis

      Optical Coherence Tomography Reveals Distinct Patterns of Retinal Damage in Neuromyelitis Optica and Multiple Sclerosis

      Background Neuromyelitis optica (NMO) and relapsing-remitting multiple sclerosis (RRMS) are difficult to differentiate solely on clinical grounds. Optical coherence tomography (OCT) studies investigating retinal changes in both diseases focused primarily on the retinal nerve fiber layer (RNFL) while rare data are available on deeper intra-retinal layers. Objective To detect different patterns of intra-retinal layer alterations in patients with NMO spectrum disorders (NMOSD) and RRMS with focus on the influence of a previous optic neuritis (ON). Methods We applied spectral-domain OCT in eyes of NMOSD patients and compared them to matched RRMS patients and healthy controls (HC). Semi-automatic intra-retinal layer segmentation ...

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    20. Optic neuritis interferes with optical coherence tomography and magnetic resonance imaging correlations

      Optic neuritis interferes with optical coherence tomography and magnetic resonance imaging correlations

      Background: Retinal nerve fibre layer (RNFL) thinning is associated with brain atrophy in multiple sclerosis (MS). An influence of optic neuritis is well documented but sparsely investigated. Recently, the retinal ganglion cell layer (GCL) has been shown to provide superior information regarding visual function and retinal neurodegeneration as compared with RNFL. Objective: To investigate the association of white and grey matter brain volume with peripapillary RNFL and macular GCL in MS patients with and without a history of optic neuritis. Methods: 63 patients with relapsing–remitting MS were included in a two-centre cross-sectional prospective study. All patients underwent retinal examination ...

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    21. Retinal Damage in Multiple Sclerosis Disease Subtypes Measured by High-Resolution Optical Coherence Tomography

      Retinal Damage in Multiple Sclerosis Disease Subtypes Measured by High-Resolution Optical Coherence Tomography

      Background. Optical coherence tomography (OCT) has facilitated characterisation of retinal alterations in MS patients. Only scarce and in part conflicting data exists on different MS subtypes. Objective. To analyse patterns of retinal changes in different subtypes of MS with latest spectral-domain technology. Methods. In a three-centre cross-sectional study 414 MS patients and 94 healthy controls underwent spectral-domain OCT examination. Results. Eyes of MS patients without a previous optic neuritis showed a significant reduction of both retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) compared to healthy controls independent of the MS subtype (P < 0.001 for all ...

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    22. Optic Nerve Head Quantification in Idiopathic Intracranial Hypertension by Spectral Domain OCT

      Optic Nerve Head Quantification in Idiopathic Intracranial Hypertension by Spectral Domain OCT

      Objective To evaluate 3D spectral domain optical coherence tomography (SDOCT) volume scans as a tool for quantification of optic nerve head (ONH) volume as a potential marker for treatment effectiveness and disease progression in idiopathic intracranial hypertension (IIH). Design and Patients Cross-sectional pilot trial comparing 19 IIH patients and controls matched for gender, age and body mass index. Each participant underwent SDOCT. A custom segmentation algorithm was developed to quantify ONH volume (ONHV) and height (ONHH) in 3D volume scans. Results Whereas peripapillary retinal nerve fiber layer thickness did not show differences between controls and IIH patients, the newly developed ...

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    23. 3D Optic Nerve Head Segmentation in Idiopathic Intracranial Hypertension

      3D Optic Nerve Head Segmentation in Idiopathic Intracranial Hypertension

      Patients with idiopathic intracranial hypertension (IIH) often present papilledema at the optic nerve head (ONH), associated with visual field losses. In order to quantify the edema, the computation of its volume is needed. Optical coherence tomography (OCT) is a noninvasive method for spatial imaging of retinal layer composition. However, current algorithms fail to segment the ONH in IIH patients satisfactorily. We developed an automatic method for segmenting the retinal pigment epithelium layer (RPE) from spatial high-resolution OCT ONH scans with robust performance in IIH patients. Using a hypothetical extension of the RPE through the ONH we were able to compute ...

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      Mentions: Friedemann Paul
    24. Impairment of contrast visual acuity as a functional correlate of retinal nerve fibre layer thinning and total macular volume reduction in multiple sclerosis

      Impairment of contrast visual acuity as a functional correlate of retinal nerve fibre layer thinning and total macular volume reduction in multiple sclerosis

      Objectives To analyse the association between retinal nerve fibre layer thickness (RNFLT) and total macular volume (TMV) as measured by optical coherence tomography, and contrast sensitivity (CS) measured by Functional Acuity Contrast Testing (FACT) in relapsing-remitting multiple sclerosis; and to investigate whether FACT testing by a contrast box device is feasible in multiple sclerosis (MS). Methods fact was performed using the Optec 6500 P vision testing system with best correction under photopic and mesopic conditions without glare. The Area Under the Log Contrast Sensitivity Function (AUC) was calculated. RNFLT and TMV were assessed by Stratus optical coherence tomography. All participants ...

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      Mentions: Friedemann Paul
    25. Patterns of retinal nerve fiber layer loss in multiple sclerosis patients with or without optic neuritis and glaucoma patients

      Patterns of retinal nerve fiber layer loss in multiple sclerosis patients with or without optic neuritis and glaucoma patients

      OBJECTIVE: Optical coherence tomography (OCT) has gained increasing attention in multiple sclerosis (MS) research and has been suggested as outcome measure for neuroprotective therapies. However, to date it is not clear whether patterns of retinal nerve fiber layer thickness (RNFLT) loss are different in MS compared to other diseases such as glaucoma and data on RNFLT loss in MS patients with or without optic neuritis (ON/NON) have remained inconsistent or even contradictory. METHODS: In this large cross-sectional study we analyzed the patterns of axonal loss of retinal ganglion cells in MS eyes (n=262) with and without history of ...

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      Mentions: Friedemann Paul
    26. Time domain and spectral domain optical coherence tomography in multiple sclerosis: A comparative cross-sectional study

      Conventional time domain optical coherence tomography has been established for the in vivo assessment of retinal axonal loss in multiple sclerosis. The innovative spectral domain imaging is superior to the conventional technique with respect to data acquisition speed, resolution and reproducibility. However, until now comparability of the two techniques has not been investigated in multiple sclerosis. In this study involving 55 multiple sclerosis patients, data obtained using both techniques (Stratus time domain optical coherence tomography and Cirrus spectral domain optical coherence tomography, Carl Zeiss Meditec) showed an excellent correlation (Pearson’s r = 0.926, p < 0.001). However, owing to ...
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    1-26 of 26
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    Patterns of retinal nerve fiber layer loss in multiple sclerosis patients with or without optic neuritis and glaucoma patients Impairment of contrast visual acuity as a functional correlate of retinal nerve fibre layer thinning and total macular volume reduction in multiple sclerosis 3D Optic Nerve Head Segmentation in Idiopathic Intracranial Hypertension Optic Nerve Head Quantification in Idiopathic Intracranial Hypertension by Spectral Domain OCT Retinal Damage in Multiple Sclerosis Disease Subtypes Measured by High-Resolution Optical Coherence Tomography Optic neuritis interferes with optical coherence tomography and magnetic resonance imaging correlations Optical Coherence Tomography Reveals Distinct Patterns of Retinal Damage in Neuromyelitis Optica and Multiple Sclerosis Retinal nerve fibre layer thickness correlates with brain white matter damage in multiple sclerosis: A combined optical coherence tomography and diffusion tensor imaging study The investigation of acute optic neuritis: a review and proposed protocol Image contrast correction method in full-field optical coherence tomography Evaluation of posterior vitreous detachment using ultrasonography and optical coherence tomography Optical coherence tomography angiography characteristics of acute retinal arterial occlusion