Journal
JOURNAL OF THE NEUROLOGICAL SCIENCES
Volume 302, Issue 1-2, Pages 19-24Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jns.2010.12.011
Keywords
Multiple sclerosis; Demyelinating disease; Neuro-ophthalmology; Optic nerve; Cup to disc ratio; Optic neuritis
Categories
Funding
- National Multiple Sclerosis Society [TR 3760-A-3, RG 4212-A-4]
- National Eye Institute [R01 EY 014993, R01 EY 019473]
- Nancy Davis Foundation
- Braxton Debbie Angela Dillon and Skip (DADS) Donor Advisor Fund
- Biogen Idec
- TEVA Neuroscience
- Athena
- Abbott Laboratories
- Aspreva
- NINDS
- EMD Serono
- Vertex
- Biogen-Idec
- Bayer
- National Multiple Sclerosis Society
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Objective: To identify and characterize cup to disc ratio (CDR) and related optic nerve head abnormalities in multiple sclerosis (MS) using spectral domain optical coherence tomography (OCT). Background: While CDR is routinely assessed by ophthalmologists in the evaluation of glaucoma, CDR and related optic nerve head metrics remain largely unexplored in MS. Design/methods: Cirrus-HD (high density) OCT was used to evaluate average CDR, vertical CDR, optic disc area, optic cup volume, and neuro-retinal rim area in 105 MS patients and 88 age-matched healthy individuals. High-contrast (100%) visual acuity, 2.5% low-contrast letter acuity and 1.25% low-contrast letter acuity were assessed in 77 MS patients. Two-sample t-tests were used in the analysis of OCT-derived optic nerve head measures between healthy controls and MS patients. Multivariate regression (accounting for age and gender) was used to assess relationships between optic nerve head measures and visual function. Results: Average CDR (p = 0.007) and vertical CDR (p = 0.005) were greater in MS patients compared to healthy controls, while neuro-retinal rim area was decreased in MS patients (p = 0.001). CDR increased with retinal nerve fiber layer (RNFL) thinning (r = 029, p = 0.001). 23% low-contrast (p = 0.005) and 1.25% low-contrast letter acuity (p = 0.03) were lower in MS patients with higher vertical CDR. Conclusions/relevance: CDR (as determined by spectral domain OCT) is abnormal in MS and correlates with visual function. OCT-derived CDR and related optic nerve head metrics may represent an objective measure by which to monitor disease progression, and potentially neuroprotection, in therapeutic MS trials. (C) 2010 Elsevier B.V. All rights reserved.
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