Transorbital Ultrasonography and Doppler Ultrasound to investigate Optic Nerves in Multiple Sclerosis

Introduction: Changes of the optic nerve (ON) reflect the overall pathology in multiple sclerosis (MS). Transorbital ultrasonogra- phy (TOUS) is currently gaining interest as a promising tool for detecting ON changes after exposure to optic neuritis. We aimed to explore both ON morphological and haemodynamic changes in a sample of MS patients. Objectives/Aims: Morphological changes in the optic nerve may potentially reflect different stages of disease in multiple sclerosis (MS) patients. In this study we aimed to explore whether tran- sorbital ultrasonography and doppler ultrasound can detect mor- phological and haemodynamic changes in a sample of MS patients. Methods: 98 subjects (27 men and 71 women, F:M=2.6) with a diagnosis of MS according to McDonald criteria, aged 48.0 (14.0) and 45.0 (12.0) (p=ns) years, were enrolled. EDSS score was 0-2.5 in 63 (64.3%) and >2.5 in 35 (35.7%) subjects. Morphometric (ON diameters) and haemodynamic (from ophthal- mic artery, OA, central retinal artery, CRA, posterior ciliary arter- ies, PCA) features were computed for affected (AE) vs. non affected (nAE) eyes. Results: A history of ON (ON+) was detected in 55 (56.1%) patients, 11 (20.0%) men and 44 (80.0%) women (p=0.058). ON+ was associated with lower EDSS scores (76.1% with EDSS 0-2.5 vs. 23.6% >2.5, p=0.006, p-trend=0.005) and although not significant with younger age (<50 years at study time). For the study population, 192 (98.0%) eyes could be investigated, 67 (34.9%) with (AE) and 125 (65.1%) without past history of docu- mented inflammation (nAE). Overall ON diameter at 3 mm (OND3), and ON sheath diameters at 3 (ONSD3) and 5 (ONSD5) mm from papilla did not differ in patients with or without a history of ON, but tended to be smaller in AE. No difference was observed for the myelination index ratio. A tendency for lower mean flow velocities for OA in AE vs. nAE was detected (p=0.070), but not for CRA and PCA. Conclusion: Transorbital ultrasonography and doppler ultrasound methods can be applied to MS patients potentially indicating loss of optic nerve volume in association to past history of ON. A larger sample size is needed for confirmatory findings

Smaller optic nerve diameters and reduced flow velocity of ophthalmic artery suggest a history of optic neuritides: Transorbital Ultrasonography and Doppler Ultrasound in multiple sclerosis

Changes of the optic nerve (ON) reflect the overall pathology in multiple sclerosis (MS). We preliminarily explored morphological and haemodynamic changes in a sample of MS patients with Transorbital Ultrasonography (TOUS) and Doppler Ultrasound (DUS). 85 MS patients, 65 women and 20 men aged 43.6 (12.1) and 45.0 (14.6) (p = ns) years, were enrolled. EDSS score was 0–2.5 in 55 (64.7%) and > 2.5 in 30 (35.3%) subjects. Morphometric (ON diameters) and haemodynamic (from ophthalmic artery, OA, central retinal artery, CRA, posterior ciliary arteries, PCA) features were computed for affected (AE) vs. non affected (nAE) eyes. ANCOVA was used to control for sex, age, number of optic neuritides (ONt). A history of ONt (hONt) was detected in 48 (28,2%) patients, 8 (16,7%) men and 40 (83,3%) women. HONt was associated with lower EDSS scores (75% with EDSS 0–2.5 vs. 25% >2.5). 160 eyes were studied, 53 (33.1%) with hONt. AE was associated with younger mean (SD) age (40.3 (10.5) vs. 44.6 (13.3) years). ON diameter at 3 mm, and ON sheath diameters at 3 and 5 mm from papilla were smaller in AE (Mann-Whitney U, p = 0.013, p = 0.033, and p = 0.026, respectively). No differences were observed for the myelination index ratio. Marginal means of flow velocities were lower for OA in AE vs. nAE (ANCOVA, p = 0.011), but not for CRA and PCA. In MS patients, smaller ON diameters and a reduced flow velocity in OA detected with TOUS and DUS may suggest hONt