In Vivo Evaluation of Retinal Neurodegeneration in Patients with Multiple Sclerosis

To evaluate macular morphology in the eyes of patients with multiple sclerosis (MS) with or without optic neuritis (ON) in previous history.Optical coherence tomography (OCT) examination was performed in thirty-nine patients with MS and in thirty-three healthy subjects. The raw macular OCT data were processed using OCTRIMA software. The circumpapillary retinal nerve fiber layer (RNFL) thickness and the weighted mean thickness of the total retina and 6 intraretinal layers were obtained for each eye. The eyes of MS patients were divided into a group of 39 ON-affected eyes, and into a group of 34 eyes with no history of ON for the statistical analyses. Receiver operating characteristic (ROC) curves were constructed to determine which parameter can discriminate best between the non-affected group and controls.The circumpapillary RNFL thickness was significantly decreased in the non-affected eyes compared to controls group only in the temporal quadrant (p = 0.001) while it was decreased in the affected eyes of the MS patients in all quadrants compared to the non-affected eyes (p<0.05 in each comparison). The thickness of the total retina, RNFL, ganglion cell layer and inner plexiform layer complex (GCL+IPL) and ganglion cell complex (GCC, comprising the RNFL and GCL+IPL) in the macula was significantly decreased in the non-affected eyes compared to controls (p<0.05 for each comparison) and in the ON-affected eyes compared to the non-affected eyes (p<0.001 for each comparison). The largest area under the ROC curve (0.892) was obtained for the weighted mean thickness of the GCC. The EDSS score showed the strongest correlation with the GCL+IPL and GCC thickness (p = 0.007, r = 0.43 for both variables).Thinning of the inner retinal layers is present in eyes of MS patients regardless of previous ON. Macular OCT image segmentation might provide a better insight into the pathology of neuronal loss and could therefore play an important role in the diagnosis and follow-up of patients with MS

Evaluation of macular morphology in patients with multiple sclerosis

Purpose To assess macular morphology in patients with multiple sclerosis (MS) with and without history of optic neuritis (ON). Methods Twenty‐six MS patients were recruited in this study, and 26 randomly eyes were selected from 26 age‐matched healthy subjects as controls. Optical coherence tomography (OCT) examination was performed on each eye using a Stratus OCT device. The raw OCT data were exported from the device and further processed using a custom‐built algorithm (OCTRIMA). Thickness measurements of 7 intraretinal layers and the total retina were obtained. Eyes from MS patients were divided into 2 groups for statistical analyses. The ON+ group contained 26 eyes which had ON at least 6 months prior to enrollment. Twenty‐three eyes had no history of ON (ON‐ group). All thickness measurements were compared among the 3 groups using ANOVA with Newman‐Keuls post‐hoc analysis. Results Significant decrease in thickness was observed in ON+ and ON‐ eyes compared to controls for the macula (290±6µm, 283±12µm and 267±12µm in the control, ON‐ and ON+ group, respectively), retinal nerve fiber layer (38±2µm, 35±2µm and 31±4µm, respectively) and ganglion cell layer and inner plexiform layer complex (71±4µm, 64±7µm and 53±7µm, respectively). No statistically significant difference in thickness was found for the remaining intraretinal layers between the 3 groups analyzed. Conclusion Atrophy of the ganglion cells and nerve fibers in the macula of MS patients was observed even without previous history of ON. Therefore, thickness measurements of ganglion cells might be useful in the diagnosis and follow‐up of MS patients

A population‐based epidemiological study of neuromyelitis optica spectrum disorder in Hungary

Background and purpose: The goal of this study was to determine the prevalence and incidence of neuromyelitis optica spectrum disorder (NMOSD) in Hungary based on the 2015 International Panel of NMO Diagnosis (IPND) criteria. Methods: A retrospective population-based cohort study was conducted of 6.4 million Hungarians (age ≥ 16 years) between 1 January 2006 and 31 December 2016. Possible NMOSD patients were selected via multistage re-evaluation from multiple sources. Crude and sex- and serostatus-specific prevalence (per 100 000 persons) and incidence rates (per 1 000 000 person-years) from 2006 to 2015 were estimated and age-adjusted rates were determined. Results: Of 2262 study candidates, 154 NMOSD patients (age ≥ 16 years) with onset until 31 December 2016 were identified based on 2015 IPND criteria. The prevalence analysis on 1 January 2016 included 123 NMOSD living cases, resulting in a prevalence of 1.91 [95% confidence interval (CI) 1.52–2.28] per 100 000 persons. The 101 incident cases emerging from the observed 76 394 288 person-years provided an incidence rate of 1.32 (95% CI 1.08–1.61) per 1 000 000 person-years. Age-adjusted prevalence was 1.87 (95% CI 1.56–2.23) per 100 000 persons and incidence was 1.20 (95% CI 0.98–1.46) per 1 000 000 person-years. Conclusions: In this first report of a large population-based epidemiological study from an Eastern European Caucasian population using robust case validation, a greater prevalence and incidence of NMOSD was found compared to previous large studies in Caucasian populations.</p