title: Retinal nerve fiber thickness in inflammatory demyelinating diseases of childhood onset.
abstract: OBJECTIVE
  To evaluate retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT) in children with acquired demyelinating diseases.
  
  
  METHODS
  This is a cross-sectional study of patients seen between 2006-2008 at the Pediatric MS Center of the Jacobs Neurological Institute. Consensus definitions for pediatric demyelinating disease were followed. All children received OCT testing and assessment of visual acuity (VA) using Snellen and low contrast letter acuity (LCLA) charts.
  
  
  RESULTS
  Thirty-eight children diagnosed with acquired demyelinating disease, 15 healthy controls, and five children with other neurological disorders (OND) were included. Average RNFLT in healthy controls was 107 +/- 12 microm(n = 30) versus 108 +/- 5 microm (n = 10) in OND controls. In children with multiple sclerosis, average RNFLT +/- SD was 99 +/- 14 microm in unaffected (n = 24) versus 83 +/- 12 micromin eyes affected by optic neuritis ("affected eyes") (n = 10). Average RNFLT in children with acute disseminated encephalomyelitis and transverse myelitis was 102 +/- 15 microm in unaffected (n = 18) versus 67 +/- 17 microm in affected eyes (n = 6). In children with optic neuritis (ON), average RNFLT +/- SD was 97 +/- 13 microm in unaffected (n = 5) versus 89 +/- 12 microm in affected eyes (n = 9). Differences between children with demyelinating disease and controls and between ON and nonON eyes were statistically significant (P < 0.001). Bivariate correlations of RNFLT with LCLA (P = 0.002) and VA (P < 0.001) were significant.
  
  
  CONCLUSIONS
  OCT may be a valuable tool for the assessment and monitoring of anterior optic pathway dysfunction in children with demyelinating diseases.
authors.affiliation: Pediatric Multiple Sclerosis Center, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Yeh
authors.forename: B
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.forename: N
authors.initials: N
authors.lastname: Lincoff
authors.forename: J
authors.initials: J
authors.lastname: Reynolds
authors.forename: A
authors.initials: A
authors.lastname: Weinstock
authors.forename: N
authors.initials: N
authors.lastname: Madurai
authors.forename: N
authors.initials: N
authors.lastname: Agarwal
authors.forename: P
authors.initials: P
authors.lastname: Buch
authors.forename: M
authors.initials: M
authors.lastname: Karpinski
authors.forename: M
authors.initials: M
authors.lastname: Ramanathan
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003711:Demyelinating Diseases / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D004673:Encephalomyelitis, Acute Disseminated / Q000473:pathology / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000473:pathology / Q000503:physiopathology; D009188:Myelitis, Transverse / Q000473:pathology / Q000503:physiopathology; D009902:Optic Neuritis / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055351:Retinal Neurons / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity