Transbulbar B-Mode Sonography in Multiple Sclerosis: Clinical and Biological Relevance

Abstract Optic nerve sheath diameter quantification by transbulbar B-mode sonography is a recently validated technique, but its clinical relevance in relapse-free multiple sclerosis patients remains unexplored. In an open-label, comparative, cross-sectional study, we aimed to assess possible differences between patients and healthy controls in terms of optic nerve sheath diameter and its correlation with clinical/paraclinical parameters in this disease. Sixty unselected relapse-free patients and 35 matched healthy controls underwent transbulbar B-mode sonography. Patients underwent routine neurologic examination, brain magnetic resonance imaging and visual evoked potential tests. The mean optic nerve sheath diameter 3 and 5 mm from the eyeball was 22–25% lower in patients than controls and correlated with the Expanded Disability Status Scale (r = −0.34, p = 0.048, and r = −0.32, p = 0.042, respectively). We suggest that optic nerve sheath diameter quantified by transbulbar B-mode sonography should be included in routine assessment of the disease as an extension of the neurologic examination

Microscopic details of age related changes in rat optic nerve

Background: Age-related changes in the number and density of optic nerve fibres were studied in 12-month-old (adult) and 24-month-old (aged) male Wistar rats. Methods: Two-micrometer-thick resin-embedded optic nerve cross-sections obtained from two different age groups were stained with toluidine blue and examined under a light microscope at low (5x) and high (500x) magnification. The optic nerve cross-sectional area, and the number of nerve fibres with diameters less or higher than 1 μm were evaluated by means of computerized image analysis and statistical analysis of results. Results: Retrobulbar optic nerve cross-sectional area decreased in relation to ageing. The number of optic nerve fibres with a diameter of less than 1 μm decreased by about 39% in 24-month-old rats versus 12 month-old animals (P 0.05). Conclusions: Data suggest that age-related impairment of nerve cell population also occurs at the optic nerve level. Our data allow us to hypothesize that all major components of the rat optic paths are sensitive to the aging process

Microscopic details of age related changes in rat optic nerve

Age-related changes in the number and density of optic nerve fibres were studied in 12-month-old (adult) and 24- month-old (aged) male Wistar rats. Methods: Two-micrometer-thick resin-embedded optic nerve cross-sections obtained from two different age groups were stained with toluidine blue and examined under a light microscope at low (5x) and high (500x) magnification. The optic nerve cross-sectional area, and the number of nerve fibres with diameters less or higher than 1 μm were evaluated by means of computerized image analysis and statistical analysis of results. Results: Retrobulbar optic nerve cross-sectional area decreased in relation to ageing. The number of optic nerve fibres with a diameter of less than 1 μm decreased by about 39% in 24-month-old rats versus 12 month-old animals (P < 0.05) while only a swelling was observed in nerve fibres with diameters higher than 1 μm ( P > 0.05). Conclusions: Data suggest that age-related impairment of nerve cell population also occurs at the optic nerve level. Our data allow us to hypothesize that all major components of the rat optic paths are sensitive to the aging process

Efficacy and safety of the intravitreal treatment of Diabetic Macular Edema with Pegaptanib: a 12-month follow-up

This observational study was performed to evaluate the efficacy and safety of intra-vitreal injections of pegaptanib during a 12-month follow-up period. Forty eyes (20 patients) affected by diabetic macular edema were monitored. Twenty were subjected to treatment, and 20 were controls. The treatment involved a cycle of three intravitreal injections of pegaptanib (0.3 mg every 6 weeks), at the end of which treated patients were submitted to a monthly follow-up for a period of 12 months. The aim was to evaluate the clinical condition of the eye after therapy and gauge the efficacy of the long-term use of this drug. Specific criteria were used to measure the efficacy and safety of pegaptanib. Regarding efficacy, we considered the following: an average improvement in the power of vision, or visual acuity, of →10 letters (2 lines), equivalent to an average logMAR score of →0.2, and a reduction in the central macular thickness of →250 μm. Regarding safety, we considered the occurrence of undesired eye and systemic side effects correlated to either the drug itself or the injection procedure. The logMAR score for the measurement of visual acuity at T3 (third intra-vitreal injection at week 13) with respect to T0 decreased from 0.7 ± 0.277 to 0.445 ± 0.216, suggesting an improvement, while the mean Early Treatment Diabetic Retinopathy Study (ETDRS) score increased from 25.75 ± 13.046 to 34.300 ± 11.770 letters. The central macular thickness was reduced from the initial value of 746.95 ± 293.601 to 334.050 ± 93.997 μm. In seven controls, we registered a worsening both in terms of visual acuity and macular thickness in some eyes, justifying a continuation of therapy in eight eyes of the control group. Pegaptanib proved to be efficacious and safe for the treatment of diabetic macular edema throughout the 12-month followup. To evaluate its long-term efficacy, further studies are required with larger numbers of patients and longer observational follow-up periods