title: Degeneration of retinal layers in multiple sclerosis subtypes quantified by optical coherence tomography.
abstract: BACKGROUND
  Optical coherence tomography can be used to assess retinal degeneration in multiple sclerosis (MS). Thinning of the retinal nerve fibre layer and macular thickness have been well characterized, but newer devices allow quantification of all retinal layers.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the thickness of the paramacular retina, peripapillary retinal nerve fibre layer, and deeper paramacular layers in MS patient subgroups, using state-of-the-art optical coherence tomography.
  
  
  METHODS
  Using a Heidelberg Engineering Spectralis device, we performed paramacular volumetric retinal scans and circular peripapillary fibre-layer scans, manually segmenting different retinal layers into single horizontal foveal scans in 95 patients with definite MS (42 relapsing-remitting, 41 secondary progressive, 12 primary progressive), plus 91 age- and sex-matched controls.
  
  
  RESULTS
  Even without a history of optic neuritis, all MS subgroups had significant thinning of the peripapillary retinal nerve fibre layer, the paramacular retinal thickness and the retinal ganglion cell- and inner plexiform layer. Only in primary progressive MS was the inner nuclear layer significantly reduced.
  
  
  CONCLUSIONS
  Our findings indicate a primary retinal pathology involving the inner nuclear layer in primary progressive MS. Results in eyes without history of optic neuritis suggest possible subclinical episodes of optic neuritis or retrograde trans-synaptic degeneration of retinal ganglion cells and their axons.
authors.affiliation: Department of Neurology, Heinrich-Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, Germany. phil.albrecht@gmail.com
authors.forename: P
authors.initials: P
authors.lastname: Albrecht
authors.forename: M
authors.initials: M
authors.lastname: Ringelstein
authors.forename: A K
authors.initials: AK
authors.lastname: Müller
authors.forename: N
authors.initials: N
authors.lastname: Keser
authors.forename: T
authors.initials: T
authors.lastname: Dietlein
authors.forename: A
authors.initials: A
authors.lastname: Lappas
authors.forename: A
authors.initials: A
authors.lastname: Foerster
authors.forename: H P
authors.initials: HP
authors.lastname: Hartung
authors.forename: O
authors.initials: O
authors.lastname: Aktas
authors.forename: A
authors.initials: A
authors.lastname: Methner
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D041623:Tomography, Optical Coherence