Retinal inner nuclear layer volume reflects inflammatory disease activity in multiple sclerosis: a longitudinal OCT study

Inner nuclear layer; Multiple sclerosis; Optical coherence tomographyCapa nuclear interna; Esclerosis múltiple; Tomografía de coherencia ópticaCapa nuclear interior; Esclerosi múltiple; Tomografia de coherència òpticaBackground: The association of peripapillary retinal nerve fibre layer (pRNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness with neurodegeneration in multiple sclerosis (MS) is well established. The relationship of the adjoining inner nuclear layer (INL) with inflammatory disease activity is less well understood. Objective: The objective of this paper is to investigate the relationship of INL volume changes with inflammatory disease activity in MS. Methods In this longitudinal, multi-centre study, optical coherence tomography (OCT) and clinical data (disability status, relapses and MS optic neuritis (MSON)) were collected in 785 patients with MS (68.3% female) and 92 healthy controls (63.4% female) from 11 MS centres between 2010 and 2017 and pooled retrospectively. Data on pRNFL, GCIPL and INL were obtained at each centre. Results: There was a significant increase in INL volume in eyes with new MSON during the study (N=61/1562, β=0.01mm3, p<.001). Clinical relapses (other than MSON) were significantly associated with increased INL volume (β=0.005, p=.025). INL volume was independent of disease progression (β=0.002mm3, p=.474). Conclusion: Our data demonstrate that an increase in INL volume is associated with MSON and the occurrence of clinical relapses. Therefore, INL volume changes may be useful as an outcome marker for inflammatory disease activity in MSON and MS treatment trials

Retinal inner nuclear layer volume reflects inflammatory disease activity in multiple sclerosis;a longitudinal OCT study

Background: The association of peripapillary retinal nerve fibre layer (pRNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness with neurodegeneration in multiple sclerosis (MS) is well established. The relationship of the adjoining inner nuclear layer (INL) with inflammatory disease activity is less well understood. Objective: The objective of this paper is to investigate the relationship of INL volume changes with inflammatory disease activity in MS. Methods In this longitudinal, multi-centre study, optical coherence tomography (OCT) and clinical data (disability status, relapses and MS optic neuritis (MSON)) were collected in 785 patients with MS (68.3% female) and 92 healthy controls (63.4% female) from 11 MS centres between 2010 and 2017 and pooled retrospectively. Data on pRNFL, GCIPL and INL were obtained at each centre. Results: There was a significant increase in INL volume in eyes with new MSON during the study (N = 61/1562, beta = 0.01mm(3), p<.001). Clinical relapses (other than MSON) were significantly associated with increased INL volume (beta = 0.005, p =.025). INL volume was independent of disease progression (beta = 0.002mm(3), p =.474). Conclusion: Our data demonstrate that an increase in INL volume is associated with MSON and the occurrence of clinical relapses. Therefore, INL volume changes may be useful as an outcome marker for inflammatory disease activity in MSON and MS treatment trials

Relation of Ouabain-Like Compounds and Intracranial Pressure in Idiopathic Intracranial Hypertension

Oubain-like compounds (OLC), present in serum and cerebrospinal fluid (CSF), are endogenous inhibitors of the Na-K ATPase pump, which is the rate limiting step in CSF formation

Optical Coherence Tomography Segmentation Analysis in Relapsing Remitting versus Progressive Multiple Sclerosis

Optical coherence tomography (OCT) is a valuable tool in assessing axonal loss and neuro-degeneration in multiple sclerosis (MS) by in-vivo imaging, nd quantification of retinal layers. The ultra-structural retinal changes in MS in different MS phenotypes can reflect differences in the pathophysiologic mechanisms. There is limited data on the pattern of deeper retinal layer involvement in progressive MS (PMS) versus relapsing remitting MS (RRMS). We have compared the OCT segmentation analysis in patients with relapsing-remitting MS and progressive MS

Retrospective analysis of ocular myasthenia gravis patients in Kuwait

The statistics of ocular myasthenia gravis is fairly well established in western literature. This study was aimed to examine the rates of conversion of ocular myasthenia to generalized myasthenia in Kuwait and their response to treatment

Orbit Case #2 - What Is It?

This symposium has been created to highlight the surgical aspects of our field and to educate neuro-ophthalmologists and trainees through the presentation and discussion of complex surgical neuro-ophthalmic case scenarios

Comparison Between inter-GCIPL, RNFL, VEP Latency in Patients with Optic Neuritis

Optic neuritis is a common manifestation of multiple sclerosis .The diagnosis of MS is heavily based on MRI findings but the latter is relatively insensitive in detecting optic nerve lesions.Identification of optic nerve lesion using ancillary tools such spectral-domain optical coherence tomography (SDOCT) by measuring the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), and visual-evoked potentials latencies (VEP) may facilitate early diagnosis and treatment of multiple sclerosis