578888
research-article2015
MSJ0010.1177/1352458515578888Multiple Sclerosis JournalO Outteryck1, B Majed
MULTIPLE SCLEROSIS MSJ JOURNAL
Original Research Paper
A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis
Multiple Sclerosis Journal 1–13 DOI: 10.1177/ 1352458515578888 © The Author(s), 2015. Reprints and permissions: http://www.sagepub.co.uk/ journalsPermissions.nav
Olivier Outteryck, Bilal Majed, Sabine Defoort-Dhellemmes, Patrick Vermersch and Hélène Zéphir
Abstract 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 MS patients; whereas MS non-optic neuritis (NON) eyes had thinner temporal (p=0.032) and temporosuperior peripapillary retinal nerve fibre layer (pRNFL; p=0.011) thicknesses than NMOSD NON eyes; in addition, NMOSD NON eyes presented significant naso-inferior pRNFL (p=0.024), temporal pRNFL (p=0.039), macular ganglion cell complex (p=0.004) and ganglion cell layer (p=0.002) atrophy vs HC eyes. We identified significant correlations between visual and clinical disability and retinal thicknesses in both diseases. Conclusion: OCT may help to differentiate NMOSD and MS by focusing on the NON eyes (temporal pRNFL atrophy more severe in MS). Moreover, we discuss the possibility of a retinal degenerative process independent of ON in NMOSD. Keywords: Neuromyelitis optica spectrum disorder, multiple sclerosis, optical coherence tomography Date received: 27 November 2014; revised: 22 February 2015; accepted: 3 March 2015 Introduction The first optical coherence tomography (OCT) studies in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) demonstrated a retinal axonal loss after optic neuritis (ON) episodes.1–5 ON in NMOSD is presumed to be more severe than in MS with more retinal nerve fibre layer (RNFL) atrophy than in MS.5 Some studies suggested that OCT could help to differentiate ON in NMOSD and MS.3,6 The aim of this study was to find, using spectral domain-OCT (SD-OCT), retinal imaging biomarkers differentiating NMOSD patients, MS patients and healthy controls (HC), which could be used for diagnostic purposes and as potential therapeutic biomarkers.
Materials and methods Study populations All included patients were followed in our centre for NMOSD or MS. All patients and HCs agreed to participate in the study, which was approved by our local ethics committee. Written informed consent was obtained from all participants. NMOSD was defined according to the Wingerchuk et al., 2014 criteria7 and MS according to the 2010 revised criteria.8 We collected demographic (gender, age, degree of myopia), clinical (disease duration, number and side of clinical ON episodes, duration since last ON episode) and biological (presence of anti-aquaporin 4 (AQP4)
Correspondence to: Olivier Outteryck Department of Neurology, University of Lille (EA2686), Hôpital Roger Salengro, 1 Rue Emile Laine, 59037 Lille Cedex, France. [email protected] Olivier Outteryck Patrick Vermersch Hélène Zéphir Department of Neurology, University of Lille, France Bilal Majed Emergency Department, Saint-Omer Region Hospital, France Sabine Defoort-Dhellemmes Department of Neuroophthalmology, University of Lille, France
http://msj.sagepub.com 1
Multiple Sclerosis Journal
Figure 1. Peripapillary and macular scans of the same multiple sclerosis (MS) patient with a past history of severe right clinical episode of optic neuritis (ON) but no left clinical episode of ON: (a) right peripapillary optical coherence tomography (OCT) scan showing severe peripapillary retinal nerve fibre layer (pRNFL) atrophy in terms of global value and predominantly in the temporal quadrant; (b) left peripapillary OCT scan showing moderate temporal pRNFL atrophy; (c) left macular OCT scan with 25 vertical lines, calculation of macular volume was made according to an ETDRS 3 mm perifovea rim; (d) one left longitudinal macular OCT scan showing microcystic macular oedema (indicated by white arrows) in the inner nuclear layer.
antibody (Ab) or not) data. Subjects presenting a disease that might impair or bias OCT measurements (glaucoma, diabetes mellitus, retinal surgery, retinal disease, uveitis, ametropia >6 diopters) or a recent relapse (
research-article2015
MSJ0010.1177/1352458515578888Multiple Sclerosis JournalO Outteryck1, B Majed
MULTIPLE SCLEROSIS MSJ JOURNAL
Original Research Paper
A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis
Multiple Sclerosis Journal 1–13 DOI: 10.1177/ 1352458515578888 © The Author(s), 2015. Reprints and permissions: http://www.sagepub.co.uk/ journalsPermissions.nav
Olivier Outteryck, Bilal Majed, Sabine Defoort-Dhellemmes, Patrick Vermersch and Hélène Zéphir
Abstract 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 MS patients; whereas MS non-optic neuritis (NON) eyes had thinner temporal (p=0.032) and temporosuperior peripapillary retinal nerve fibre layer (pRNFL; p=0.011) thicknesses than NMOSD NON eyes; in addition, NMOSD NON eyes presented significant naso-inferior pRNFL (p=0.024), temporal pRNFL (p=0.039), macular ganglion cell complex (p=0.004) and ganglion cell layer (p=0.002) atrophy vs HC eyes. We identified significant correlations between visual and clinical disability and retinal thicknesses in both diseases. Conclusion: OCT may help to differentiate NMOSD and MS by focusing on the NON eyes (temporal pRNFL atrophy more severe in MS). Moreover, we discuss the possibility of a retinal degenerative process independent of ON in NMOSD. Keywords: Neuromyelitis optica spectrum disorder, multiple sclerosis, optical coherence tomography Date received: 27 November 2014; revised: 22 February 2015; accepted: 3 March 2015 Introduction The first optical coherence tomography (OCT) studies in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) demonstrated a retinal axonal loss after optic neuritis (ON) episodes.1–5 ON in NMOSD is presumed to be more severe than in MS with more retinal nerve fibre layer (RNFL) atrophy than in MS.5 Some studies suggested that OCT could help to differentiate ON in NMOSD and MS.3,6 The aim of this study was to find, using spectral domain-OCT (SD-OCT), retinal imaging biomarkers differentiating NMOSD patients, MS patients and healthy controls (HC), which could be used for diagnostic purposes and as potential therapeutic biomarkers.
Materials and methods Study populations All included patients were followed in our centre for NMOSD or MS. All patients and HCs agreed to participate in the study, which was approved by our local ethics committee. Written informed consent was obtained from all participants. NMOSD was defined according to the Wingerchuk et al., 2014 criteria7 and MS according to the 2010 revised criteria.8 We collected demographic (gender, age, degree of myopia), clinical (disease duration, number and side of clinical ON episodes, duration since last ON episode) and biological (presence of anti-aquaporin 4 (AQP4)
Correspondence to: Olivier Outteryck Department of Neurology, University of Lille (EA2686), Hôpital Roger Salengro, 1 Rue Emile Laine, 59037 Lille Cedex, France. [email protected] Olivier Outteryck Patrick Vermersch Hélène Zéphir Department of Neurology, University of Lille, France Bilal Majed Emergency Department, Saint-Omer Region Hospital, France Sabine Defoort-Dhellemmes Department of Neuroophthalmology, University of Lille, France
http://msj.sagepub.com 1
Multiple Sclerosis Journal
Figure 1. Peripapillary and macular scans of the same multiple sclerosis (MS) patient with a past history of severe right clinical episode of optic neuritis (ON) but no left clinical episode of ON: (a) right peripapillary optical coherence tomography (OCT) scan showing severe peripapillary retinal nerve fibre layer (pRNFL) atrophy in terms of global value and predominantly in the temporal quadrant; (b) left peripapillary OCT scan showing moderate temporal pRNFL atrophy; (c) left macular OCT scan with 25 vertical lines, calculation of macular volume was made according to an ETDRS 3 mm perifovea rim; (d) one left longitudinal macular OCT scan showing microcystic macular oedema (indicated by white arrows) in the inner nuclear layer.
antibody (Ab) or not) data. Subjects presenting a disease that might impair or bias OCT measurements (glaucoma, diabetes mellitus, retinal surgery, retinal disease, uveitis, ametropia >6 diopters) or a recent relapse (
