1. Articles from Neurology

    n.neurology.org

  2. 1-12 of 12
    1. Optical coherence tomography for detection of asymptomatic optic nerve lesions in clinically isolated syndrome

      Optical coherence tomography for detection of asymptomatic optic nerve lesions in clinically isolated syndrome

      Objective To evaluate the ability of intereye retinal thickness difference (IETD) measured by optical coherence tomography (OCT) to detect asymptomatic optic nerve involvement in clinically isolated syndrome (CIS). Methods We conducted a cross-sectional study of patients who recently presented a CIS (≤4.5 months). All patients underwent OCT and brain/optic nerve MRI. Optic nerve involvement was defined clinically (episode of optic neuritis [ON] or not) and radiologically (optic nerve hypersignal on 3D double inversion recovery [3D-DIR]). We evaluated the sensitivity and specificity of previously published IETD thresholds and report the observed optimal thresholds for identifying symptomatic optic nerve involvement ...

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    2. Optical coherence tomography: A useful tool for identifying subclinical optic neuropathy in diagnosing multiple sclerosis

      Optical coherence tomography: A useful tool for identifying subclinical optic neuropathy in diagnosing multiple sclerosis

      Care of patients with multiple sclerosis (MS) has evolved in the last decade to shorten the time to confirm the diagnosis of clinically definite MS and to start disease-modifying drugs as soon as possible to decrease permanent disability and the risk of progressive disease. Such trends have been achieved by improving our understanding of the role of paraclinical tests such as the presence of oligoclonal bands on CSF examination, visual evoked potentials, or MRI imaging of the brain or spinal cord. Recently, the evidence that retinal damage detected with optical coherence tomography (OCT) is a sensitive test for identifying MS-related ...

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    3. Editors' note: Optical coherence tomography for diagnosing optic neuritis: Are we there yet?

      Editors' note: Optical coherence tomography for diagnosing optic neuritis: Are we there yet?

      In the editorial “Optical coherence tomography for diagnosing optic neuritis: Are we there yet?,” Drs. Saidha and Naismith discussed the potential application of optical coherence tomography (OCT) in providing objective support for previous optic neuritis (ON) and in highlighting the research article by Drs. Xu et al. entitled “Optical coherence tomography is highly sensitive in detecting prior optic neuritis.” In a reader response, Dr. Avasarala highlights several potential issues hindering the use of OCT in this context, including the cost of OCT hardware, continually changing algorithms for retinal segmentation, and the paucity of data on OCT's performance relative to ...

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    4. Reader response: Optical coherence tomography for diagnosing optic neuritis: Are we there yet?

      Reader response: Optical coherence tomography for diagnosing optic neuritis: Are we there yet?

      I read with interest the editorial by Drs. Saidha and Naismith. 1 The corresponding study by Xu et al. 2 that reported the sensitivity of detecting previous optic neuritis (ON) is elegant. However, many questions remain. One of the reasons why neurologists in the United States do not use optical coherence tomography (OCT) routinely is because of the high cost of hardware and the continually changing algorithms that are used to perform retinal segmentation. In addition, why not use pattern shift visual evoked response data that shows delayed P100 latencies in most patients, even with visual recovery in detecting previous ...

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    5. Author response: Optical coherence tomography for diagnosing optic neuritis: Are we there yet?

      Author response: Optical coherence tomography for diagnosing optic neuritis: Are we there yet?

      We thank Dr. Avasarala for his comments on our editorial regarding the corresponding study by Xu et al., 1,2 in which the sensitivity of optical coherence tomography (OCT) measures for detecting previous optic neuritis (ON) was examined. Although Naismith et al. reported that OCT was less sensitive than visual evoked potentials (VEP) in detecting previous ON, 3 this study used older third-generation time domain OCT. Undoubtedly, the greatest advance in OCT in the past decade has been the development of fourth-generation spectral domain OCT. Current commercially available spectral domain OCT has extremely high resolution (3–5 μm). Moreover, peripapillary ...

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    6. Optical coherence tomography is highly sensitive in detecting prior optic neuritis

      Optical coherence tomography is highly sensitive in detecting prior optic neuritis

      Objective To explore sensitivity of optical coherence tomography (OCT) in detecting prior unilateral optic neuritis. Methods This is a retrospective, observational clinical study of all patients who presented from January 1, 2014, to January 6, 2017, with unilateral optic neuritis and OCT available at least 3 months after the attack. We compared OCT retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses between affected and unaffected contralateral eyes. We excluded patients with concomitant glaucoma or other optic neuropathies. Based on analysis of normal controls, thinning was considered significant if RNFL was at least 9 µm or ...

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      Mentions: Randy H. Kardon
    7. Optical coherence tomography for diagnosing optic neuritis Are we there yet?

      Optical coherence tomography for diagnosing optic neuritis Are we there yet?

      Acute optic neuritis (ON) results in rapid and prominent peripapillary retinal nerve fiber layer (RNFL) and composite ganglion cell and inner plexiform layer (GCIPL) thinning, as measured with optical coherence tomography (OCT). However, the degree of thinning within these layers following ON is heterogeneous, varying across patients, even within the same disease state. 1 Moreover, OCT measures in healthy individuals have a broad range, creating difficulties establishing an absolute diagnostic cutoff for prior ON with good sensitivity and specificity. Whereas earlier generation time-domain OCT could be insensitive to subtle RNFL changes following ON, 2 and less sensitive than visual evoked ...

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    8. Diagnosis and treatment evaluation of in-stent restenosis of carotid artery stenting using optical coherence tomography

      Diagnosis and treatment evaluation of in-stent restenosis of carotid artery stenting using optical coherence tomography

      A 65-year-old man underwent balloon angioplasty and repeat carotid artery stenting (CAS) due to in-stent restenosis (ISR). Intravascular optical coherence tomography (OCT) showed a severe ISR with fibrotic neointimal growth ( figure 1 ). Post 6.0 × 30 mm balloon angioplasty, OCT showed intimal disruption and artery dissection ( figure 2 ). After the 8 × 40 mm stent fully expanded, OCT showed stent struts well apposed, but tissue protrusion from the spaces between stent struts can be observed ( figure 2 ). OCT allowed measurement of intimal hyperplasia after the CAS and observation of intimal disruption and stent strut apposition intraoperatively. 1 , 2

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    9. Retinal and optic nerve changes in microcephaly: An optical coherence tomography study

      Retinal and optic nerve changes in microcephaly:  An optical coherence tomography study

      Objective To investigate the morphology of the retina and optic nerve (ON) in microcephaly. Methods This was a prospective case-control study including 27 patients with microcephaly and 27 healthy controls. All participants underwent ophthalmologic examination and handheld optical coherence tomography (OCT) of the macula and ON head. The thickness of individual retinal layers was quantified at the foveal center and the parafovea (1,000 μm nasal and temporal to the fovea). For the ON head, disc diameter, cup diameter, cup-to-disc ratio, cup depth, horizontal rim diameter, rim area, peripapillary retinal thickness, and retinal nerve fiber layer thickness were measured. Results ...

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    10. Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study

      Retinal signs and 20-year cognitive decline in the Atherosclerosis Risk in Communities Study

      Objective To test the hypothesis that retinal vascular signs are associated with greater cognitive decline over 20 years in 12,317 men and women 50 to 73 years of age at baseline. Methods A composite cognitive score was created with 3 neuropsychological tests measured at 3 time points (1990–1992 to 2011–2013). Retinal signs were measured with fundus photography (1993–1995). Differences in cognitive change by retinal signs status were estimated with linear mixed models. Cognitive scores were imputed for living participants with incomplete cognitive testing. Results In multivariable-adjusted analyses that controlled for attrition, loss of vascular integrity (retinopathy ...

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    11. Carotid artery stenting with optical coherence tomography

      Carotid artery stenting with optical coherence tomography

      A 61-year-old man underwent a left cervical internal carotid artery stenting following a recent ischemic stroke. Postoperative angiography was satisfactory and did not reveal any in-stent filling defect ( figure 1A ). Optical coherence tomography (OCT) probe was used to visualize the endoluminal area following stenting. OCT confirmed optimum placement of the stent and reveled a small plaque protrusion from the stent struts following deployment ( figure 1B ).

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    12. No evidence of disease activity is associated with reduced rate of axonal retinal atrophy in MS

      No evidence of disease activity is associated with reduced rate of axonal retinal atrophy in MS

      Objective: To explore, in a longitudinal study, the usefulness of optical coherence tomography (OCT) in monitoring people with multiple sclerosis (MS) by testing the association between retinal nerve fiber layer (RNFL) thinning and clinical and brain MRI criteria of no evidence of disease activity (NEDA). Methods: OCT, visual evoked potentials (VEPs), and disability, using the Expanded Disability Status Scale (EDSS), were tested at baseline and after 2 years in 72 patients, 63 with routine yearly brain MRI. Results: Longitudinal mean binocular RNFL thinning, in absence of optic neuritis during follow-up, was correlated with EDSS worsening, also controlling for baseline EDSS ...

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    1-12 of 12
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