title: Patterns of retinal nerve fiber layer loss in multiple sclerosis patients with or without optic neuritis and glaucoma patients.
abstract: OBJECTIVE
  Optical coherence tomography (OCT) has gained increasing attention in multiple sclerosis (MS) research and has been suggested as outcome measure for neuroprotective therapies. However, to date it is not clear whether patterns of retinal nerve fiber layer thickness (RNFLT) loss are different in MS compared to other diseases such as glaucoma and data on RNFLT loss in MS patients with or without optic neuritis (ON/NON) have remained inconsistent or even contradictory.
  
  
  METHODS
  In this large cross-sectional study we analyzed the patterns of axonal loss of retinal ganglion cells in MS eyes (n=262) with and without history of ON (MS/ON: 73 eyes; MS/NON: 189 eyes) and patients eyes with glaucomatous optic disc atrophy (GA: n=22; 39 eyes) in comparison to healthy control eyes (HC: n=406 eyes).
  
  
  RESULTS
  We found that significant average and quadrant RNFLT loss is detectable by OCT in both MS and GA patients compared to healthy controls (p<0.01). The age- and gender adjusted average and quadrant RNFLT did not differ significantly between MS and GA patients (p>0.05). Average (p<0.0001) and quadrant (p<0.05) RNFL thinning is significantly more severe in MS/ON versus MS/NON eyes, and the extent of RNFL thinning varies across quadrants in MS/ON eyes with the highest degree of RNFLT loss in the temporal quadrant (p<0.001).
  
  
  CONCLUSIONS
  RNFLT reduction across all four quadrants in MS patients as a whole as well as in MS/NON eyes argues for a diffuse neurodegenerative process. Superimposed inflammatory attacks to the optic nerve may cause additional axonal damage with a temporal preponderance. Future studies are necessary to further evaluate the capacity of OCT to depict disease specific damage patterns.
authors.affiliation: Cecilie Vogt Clinic, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Bock
authors.forename: Alexander U
authors.initials: AU
authors.lastname: Brandt
authors.forename: Jan
authors.initials: J
authors.lastname: Dörr
authors.forename: Helga
authors.initials: H
authors.lastname: Kraft
authors.forename: Nicholetta
authors.initials: N
authors.lastname: Weinges-Evers
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gaede
authors.forename: Caspar F
authors.initials: CF
authors.lastname: Pfueller
authors.forename: Katja
authors.initials: K
authors.lastname: Herges
authors.forename: Helena
authors.initials: H
authors.lastname: Radbruch
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ohlraun
authors.forename: Judith
authors.initials: J
authors.lastname: Bellmann-Strobl
authors.forename: Jörn
authors.initials: J
authors.lastname: Kuchenbecker
authors.forename: Frauke
authors.initials: F
authors.lastname: Zipp
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
mesh_terms: D000328:Adult; D001284:Atrophy; D001369:Axons / Q000473:pathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology*; D009410:Nerve Degeneration / Q000209:etiology / Q000473:pathology*; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology; D009902:Optic Neuritis / Q000150:complications / Q000473:pathology*; D012016:Reference Values; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence