1. 1-21 of 21
    1. Optical coherence tomography indicates disease activity prior to clinical onset of central nervous system demyelination

      Optical coherence tomography indicates disease activity prior to clinical onset of central nervous system demyelination

      Background: Establishing biomarkers for predicting disease activity in demyelinating disease of the central nervous system is crucial for designing appropriate disease modifiying treatment strategies. Objective: To investigate retinal findings and disease activity in patients with radiologically isolated and clinically isolated syndromes. Methods: We performed retinal optical coherence tomography and cerebral magnetic resonance imaging in healthy control individuals ( n =19), in individuals with non-specific white matter lesions ( n =18), and in patients with clinically isolated syndromes ( n =18) and radiologically isolated syndromes ( n =20). Results: Reduced volume of retinal nerve fibre layer and increased volume of inner nuclear layer at baseline ...

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    2. A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis

      A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis

      Objectives: The aim of this study was to find, using spectral domain-optical coherence tomography (SD-OCT), retinal imaging biomarkers differentiating neuromyelitis optica spectrum disorder (NMOSD), multiple sclerosis (MS) and healthy controls (HCs). Materials and methods: The population was composed of patients with NMOSD ( n =23) or MS ( n =110) and of HCs ( n =75). Evaluation criteria were retinal thickness/volume, visual acuity, low contrast vision acuity and Expanded Disability Status Scale score. Results: Considering all eyes and after statistical adjustments including the number of optic neuritis (ON) episodes, we found that NMOSD patients did not have significantly more retinal atrophy than ...

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    3. Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography

      Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography

      Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel aquaporin-4 present in up to 80% of NMO patients enables distinction from MS. Optic neuritis may occur in either condition resulting in neuro-anatomical retinal changes. Optical coherence tomography (OCT) has become a useful tool for analyzing retinal damage both in MS and NMO. Numerous studies showed that optic neuritis in NMO typically results in more severe retinal nerve fiber ...

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    4. Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: No

      Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: No

      Optical coherence tomography (OCT) is an exciting technique that has been applied to multiple sclerosis (MS) research for around the last 10 years. OCT enables rapid, non-invasive in vivo measurement of retinal nerve fibre layer (RNFL) thickness, reflecting neuroaxonal density within the optic nerve. Early studies applied to post-acute optic neuritis 1 demonstrate neuroaxonal loss. Further research extended the scope of OCT, finding that its measures appeared to be a useful surrogate of generalised brain axonal loss in MS patients; progressive RNFL thinning was evident even in the absence of a history of optic neuritis, 2 and RNFL thickness was ...

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    5. Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: Yes

      Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: Yes

      Magnetic resonance imaging (MRI) of the brain is the most widely established imaging modality for monitoring multiple sclerosis (MS). Although conventional MRI parameters such as the development of new T2 lesions and/or contrast-enhancing lesions are sensitive to inflammatory disease activity, the association between MRI markers of inflammation and disability progression in MS is modest. 1 Conversely, MRI measures of neurodegeneration, such as whole-brain atrophy, correlate well with disability progression, 2 with neurodegeneration considered the principal pathological substrate underlying disability in MS. MRI segmentation techniques also enable the measurement of brain substructure volumes. Gray matter (GM) atrophy is now recognized ...

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    6. Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: Commentary

      Optical coherence tomography should be part of the routine monitoring of patients with multiple sclerosis: Commentary

      There is no doubt that optical coherence tomography (OCT) has been an extremely exciting development for medicine and for multiple sclerosis (MS). The value of OCT as a diagnostic tool has been demonstrated and it has been to shown to identify patients with highly active disease (but magnetic resonance imaging (MRI) does both better). Its possible use as an instrument to measure neurodegeneration over time is perhaps the application most welcome to MS neurologists. Readers are directed to a systematic review of OCT 1 and a discussion of the potential and the problems associated with OCT by Green. 2 An ...

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    7. Disease course heterogeneity and OCT in multiple sclerosis

      Disease course heterogeneity and OCT in multiple sclerosis

      Background: The heterogeneity of the disease course in multiple sclerosis (MS) remains a challenge for patient management and clinical trials. Objective: The objective of this paper is to investigate the relationship between disease course heterogeneity and retinal layer thicknesses in MS. Methods: A total of 230 MS patients and 63 healthy control subjects were included. Spectral-domain OCT scanning of the peripapillary and macular regions was performed, followed by automated eight-layer segmentation. Generalised estimation equations were used for comparisons. Receiver operating characteristic (ROC) curves were calculated for distinguishing a benign from a typical disease course. Results: Primary progressive patients showed relative ...

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    8. Quality control for retinal OCT in multiple sclerosis: validation of the OSCAR-IB criteria

      Quality control for retinal OCT in multiple sclerosis: validation of the OSCAR-IB criteria

      Background: Retinal optical coherence tomography (OCT) permits quantification of retinal layer atrophy relevant to assessment of neurodegeneration in multiple sclerosis (MS). Measurement artefacts may limit the use of OCT to MS research. Objective: An expert task force convened with the aim to provide guidance on the use of validated quality control (QC) criteria for the use of OCT in MS research and clinical trials. Methods: A prospective multi-centre ( n = 13) study. Peripapillary ring scan QC rating of an OCT training set ( n = 50) was followed by a test set ( n = 50). Inter-rater agreement was calculated using kappa statistics. Results were ...

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    9. 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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    10. Optical coherence tomography and visual evoked potentials: which is more sensitive in multiple sclerosis?

      Optical coherence tomography and visual evoked potentials: which is more sensitive in multiple sclerosis?

      Objective: To assess the sensitivity of optic coherence tomography (OCT) and visual evoked potentials (VEPs) to visual pathway abnormalities in multiple sclerosis (MS). Methods: A total of 40 MS subjects, 28 with optic neuritis (ON) at least 3 months before (bilateral in 5), underwent assessment of visual acuity, Expanded Disability Status Scale (EDSS), OCT and VEPs, the latter quantified with a 0–4 conventional score. Results: OCT and VEPs were abnormal in 36% and 56% respectively in all eyes ( p =0.11), 68% and 86% in eyes with previous ON ( p =0.12), and in 19% versus 40% in eyes ...

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    11. Longitudinal follow-up of vision in a neuromyelitis optica cohort

      Longitudinal follow-up of vision in a neuromyelitis optica cohort

      Background: Neuromyelitis optica (NMO) is an inflammatory disease associated with optic neuritis and myelitis. Recently, several studies showed that optical coherence tomography (OCT) could be an interesting method for the evaluation of disease severity; however, to date there are no studies with a longitudinal follow-up of visual function in NMO. The aim of this study was to assess the ability of OCT to evaluate the progression of visual dysfunction in NMO. Patients and methods: A group of 30 NMO patients (thus, 60 eyes), comprised of 20 women and 10 men with a mean age of 43.7 +/− 12.3 years ...

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    12. 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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    13. Degeneration of retinal layers in multiple sclerosis subtypes quantified by optical coherence tomography

      Degeneration of retinal layers in multiple sclerosis subtypes quantified by optical coherence tomography

      Background: Optical coherence tomography can be used to assess retinal degeneration in multiple sclerosis (MS). Thinning of the retinal nerve fibre layer and macular thickness have been well characterized, but newer devices allow quantification of all retinal layers. Objectives: The objective of this study was to evaluate the thickness of the paramacular retina, peripapillary retinal nerve fibre layer, and deeper paramacular layers in MS patient subgroups, using state-of-the-art optical coherence tomography. Methods: Using a Heidelberg Engineering Spectralis device, we performed paramacular volumetric retinal scans and circular peripapillary fibre-layer scans, manually segmenting different retinal layers into single horizontal foveal scans in ...

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    14. Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

      Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

      Background: Post-mortem analyses of multiple sclerosis (MS) eyes demonstrate prominent retinal neuronal ganglion cell layer (GCL) loss, in addition to related axonal retinal nerve fiber layer (RNFL) loss. Despite this, clinical correlations of retinal neuronal layers remain largely unexplored in MS. Objectives: To determine if MS patients exhibit in vivo retinal neuronal GCL loss, deeper retinal neuronal loss, and investigate correlations between retinal layer thicknesses, MS clinical subtype and validated clinical measures. Methods: Cirrus HD-optical coherence tomography (OCT), utilizing automated intra-retinal layer segmentation, was performed in 132 MS patients and 78 healthy controls. MS classification, Expanded Disability Status Scale (EDSS ...

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    15. Reproducibility of high-resolution optical coherence tomography in multiple sclerosis

      Reproducibility of high-resolution optical coherence tomography in multiple sclerosis

      Optical coherence tomography (OCT) is a non-invasive method to quantify neurodegeneration as an outcome in multiple sclerosis clinical trials; however, no data exist on Cirrus spectral domain optical coherence tomography (SD-OCT) reproducibility in patients with multiple sclerosis. The objective of this study was to determine the protocol for achieving optimal inter-visit, inter-rater, and intra-rater reproducibility for studies performed on healthy controls and multiple sclerosis patients utilizing novel high-definition SD-OCT. This is a prospective study of inter-visit, inter-rater, and intra-rater reproducibility in multiple sclerosis patients (n = 58) and healthy controls (n = 32) on Cirrus-HD SD-OCT. Excellent reproducibility of average and quadrantic ...

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    16. 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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    17. Comparison of multifocal visual evoked potential, standard automated perimetry and optical coherence tomography in assessing visual pathway in multiple sclerosis patients

      Background: Multifocal visual evoked potentials (mfVEP) measure local response amplitude and latency in the field of vision. Objective: To compare the sensitivity of mfVEP, Humphrey visual field (HVF) and optical coherence tomography (OCT) in detecting visual abnormality in multiple sclerosis (MS) patients. Methods: mfVEP, HVF, and OCT (retinal nerve fiber layer [RNFL]) were performed in 47 MS-ON eyes (last optic neuritis [ON] attack 6 months prior) and 65 MS-no-ON eyes without ON history. Criteria to define an eye as abnormal were: (1) mfVEP amplitude/latency – either amplitude or latency probability plots meeting cluster criteria with 95% specificity; (2) mfVEP amplitude ...
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    18. Retinal nerve fiber thickness in inflammatory demyelinating diseases of childhood onset

      Purpose B Weinstock-Guttman To evaluate retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT) in children with acquired demyelinating diseases.MethodsThis is a cross-sectional study of patients seen between 2006–2008 at the Pediatric MS Center of the Jacobs Neurological Institute. Consensus definitions for pediatric demyelinating disease were followed. All children received OCT testing and assessment of visual acuity (VA) using Snellen and low contrast letter acuity (LCLA) charts.ResultsThirty-eight children diagnosed with acquired demyelinating disease, 15 healthy controls, and five children with other neurological disorders (OND) were included. Average RNFLT in healthy controls was 107 ± 12 µm ...
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    19. Retinal architecture predicts pupillary reflex metrics in MS

      Objective To study the relation of retinal nerve fiber layer thinning to clinical and physiologic measures of visual function in patients with MS or neuromyelitis optica and unilateral optic neuropathy.MethodsWe studied a cohort of control subjects (n = 64) and patients (n = 24) with evidence of unilateral thinning of their average retinal nerve fiber layer as measured by optical coherence tomography in order to characterize the relationship between ganglion cell axonal degeneration and its impact upon vision and pupillary light reflex metrics using infrared pupillometry. Results When compared to the normal fellow eye, and with respect to normal subjects’ eyes ...
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    20. Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis

      BackgroundStudying axonal loss in the retina is a promising biomarker for multiple sclerosis (MS). Our aim was to compare optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT) techniques to measure the thickness of the retinal nerve fiber layer (RNFL) in patients with MS, and to explore the relationship between changes in the RNFL thickness with physical and cognitive disability. We studied 52 patients with MS and 18 proportionally matched controls by performing neurological examination, neuropsychological evaluation using the Brief Repetitive Battery-Neuropsychology and RNFL thickness measurement using OCT and HRT.ResultsWe found that both OCT and HRT could define a ...
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    21. Tracking retinal nerve fiber layer loss after optic neuritis: a prospective study using optical coherence tomography

      Introduction Optic neuritis causes retinal nerve fiber layer damage, which can be quantified with optical coherence tomography. Optical coherence tomography may be used to track nerve fiber layer changes and to establish a time-dependent relationship between retinal nerve fiber layer thickness and visual function after optic neuritis. Methods This prospective case series included 78 patients with optic neuritis, who underwent optical coherence tomography and visual testing over a mean period of 28 months. The main outcome measures included comparing inter-eye differences in retinal nerve fiber layer thickness between clinically affected and non-affected eyes over time; establishing when RNFL thinning stabilized ...

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    1-21 of 21
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