title: Retinal ganglion cell and inner plexiform layer thinning in clinically isolated syndrome.
abstract: BACKGROUND
  Axonal and neuronal damage are widely accepted as key events in the disease course of multiple sclerosis. However, it has been unclear to date at which stage in disease evolution neurodegeneration begins and whether neuronal damage can occur even in the absence of acute inflammatory attacks.
  
  
  OBJECTIVE
  To characterize inner retinal layer changes in patients with clinically isolated syndrome (CIS).
  
  
  METHODS
  45 patients with CIS and age- and sex-matched healthy controls were investigated using spectral domain optical coherence tomography. Patients' eyes were stratified into the following categories according to history of optic neuritis (ON): eyes with clinically-diagnosed ON (CIS-ON), eyes with suspected subclinical ON (CIS-SON) as indicated by a visual evoked potential latency of >115 ms and eyes unaffected by ON (CIS-NON).
  
  
  RESULTS
  CIS-NON eyes showed significant reduction of ganglion cell- and inner plexiform layer and a topography similar to that of CIS-ON eyes. Seven eyes were characterized as CIS-SON and likewise showed significant retinal layer thinning. The most pronounced thinning was present in CIS-ON eyes.
  
  
  CONCLUSIONS
  Our findings indicate that retinal pathology does occur already in CIS. Intraretinal layer segmentation may be an easily applicable, non-invasive method for early detection of retinal pathology in patients unaffected by ON.
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité University Medicine Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Oberwahrenbrock
authors.forename: Marius
authors.initials: M
authors.lastname: Ringelstein
authors.forename: Simon
authors.initials: S
authors.lastname: Jentschke
authors.forename: Katrin
authors.initials: K
authors.lastname: Deuschle
authors.forename: Katharina
authors.initials: K
authors.lastname: Klumbies
authors.forename: Judith
authors.initials: J
authors.lastname: Bellmann-Strobl
authors.forename: Jens
authors.initials: J
authors.lastname: Harmel
authors.forename: Klemens
authors.initials: K
authors.lastname: Ruprecht
authors.forename: Sven
authors.initials: S
authors.lastname: Schippling
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Orhan
authors.initials: O
authors.lastname: Aktas
authors.forename: Alexander U
authors.initials: AU
authors.lastname: Brandt
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003711:Demyelinating Diseases / Q000473:pathology* / Q000503:physiopathology; D042241:Early Diagnosis; D005074:Evoked Potentials, Visual; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D055815:Young Adult
keywords: Clinically isolated syndrome; optical coherence tomography; retinal ganglion cell layer; retinal nerve fiber layer