title: Predictive value of 1 month retinal nerve fiber layer thinning for deficits at 6 months after acute optic neuritis.
abstract: BACKGROUND
  Retinal nerve fiber layer (RNFL) loss occurs with multiple sclerosis and after optic neuritis. Vision or RNFL changes at presentation of optic neuritis are not predictive of outcome, but vision loss at 1 month correlates with vision deficits at 6 months. We hypothesized that RFNL thinning at 1 month would predict RNFL loss at 6 months.
  
  
  METHODS
  We prospectively studied the RNFL by optical coherence tomography (OCT) and scanning laser polarimetry (SLP), and determined the threshold field mean deviation, in 25 subjects with acute optic neuritis over a 6-month period. RNFL values, including the amount of thinning at 1-month, were correlated with 6-month outcome.
  
  
  RESULTS
  Baseline visual performance and RNFL values were similar for eyes grouped by 1 month RNFL thinning. Eyes with 1 month RNFL thinning had greater and significant RNFL thinning at 6 months, for all quadrants by OCT and for the nasal and inferior quadrants by SLP. RNFL thinning by OCT and SLP at 1 month correlated with 6-month OCT (r = 0.58; p = 0.006) and SLP (r = 0.59; p = 0.002) RNFL thinning, respectively.
  
  
  CONCLUSIONS
  Early RNFL loss at 1 month was predictive of the RNFL thinning at 6 months, which corroborated the importance of the 1-month time point for predicting the outcome of an optic neuritis attack.
authors.affiliation: Institute of Neurology and Neurosurgery (INN), Roosevelt Hospital, New York, NY, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Kupersmith
authors.forename: Susan
authors.initials: S
authors.lastname: Anderson
authors.forename: Randy
authors.initials: R
authors.lastname: Kardon
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009900:Optic Nerve / Q000473:pathology*; D009902:Optic Neuritis / Q000150:complications / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D057109:Scanning Laser Polarimetry; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D014787:Vision Tests
keywords: Outcome measurement; axonal loss; nerve thinning; optic neuritis; outcome prediction; retinal nerve fiber layer; visual impairment