title: High resolution spectral domain optical coherence tomography (SD-OCT) in multiple sclerosis: the first follow up study over two years.
abstract: BACKGROUND
  "Non-invasive, faster and less expensive than MRI" and "the eye is a window to the brain" are recent slogans promoting optical coherence tomography (OCT) as a new surrogate marker in multiple sclerosis (MS). Indeed, OCT allows for the first time a non-invasive visualization of axons of the central nervous system (CNS). Reduction of retina nerve fibre layer (RNFL) thickness was suggested to correlate with disease activity and duration. However, several issues are unclear: Do a few million axons, which build up both optic nerves, really resemble billions of CNS neurons? Does global CNS damage really result in global RNFL reduction? And if so, does global RNFL reduction really exist in all MS patients, and follow a slowly but steadily ongoing pattern? How can these (hypothesized) subtle global RNFL changes be reliably measured and separated from the rather gross RNFL changes caused by optic neuritis? Before generally being accepted, this interpretation needs further critical and objective validation.
  
  
  METHODS
  We prospectively studied 37 MS patients with relapsing remitting (n = 27) and secondary progressive (n = 10) course on two occasions with a median interval of 22.4±0.5 months [range 19-27]. We used the high resolution spectral domain (SD-)OCT with the Spectralis 3.5 mm circle scan protocol with locked reference images and eye tracking mode. Patients with an attack of optic neuritis within 12 months prior to the onset of the study were excluded.
  
  
  RESULTS
  Although the disease was highly active over the observation period in more than half of the included relapsing remitting MS patients (19 patients/32 relapses) and the initial RNFL pattern showed a broad range, from normal to markedly reduced thickness, no significant changes between baseline and follow-up examinations could be detected.
  
  
  CONCLUSIONS
  These results show that caution is required when using OCT for monitoring disease activity and global axonal injury in MS.
authors: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors: Nermin
authors: N
authors: Serbecic
authors: Fahmy
authors: F
authors: Aboul-Enein
authors: Sven C
authors: SC
authors: Beutelspacher
authors: Clemens
authors: C
authors: Vass
authors: Wolfgang
authors: W
authors: Kristoferitsch
authors: Hans
authors: H
authors: Lassmann
authors: Andreas
authors: A
authors: Reitner
authors: Ursula
authors: U
authors: Schmidt-Erfurth
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