title: Optical coherence tomography in patients with a history of juvenile multiple sclerosis reveals early retinal damage.
abstract: OBJECTIVE
  Some 3%-10% of patients with multiple sclerosis (MS) experience disease onset before the age of 18 years ('early' onset MS, EOMS). Optical coherence tomography is a non-invasive method to measure retinal nerve fibre layer thickness (RNFLT) and total macular volume (TMV) and may be useful to differentiate axonal and neuronal damage in the retina of patients with a history of EOMS. Here RNFLT and TMV in EOMS patients after a mean disease duration of 11.6 years were compared with patients with age- or disease-duration-matched later onset MS (LOMS) and healthy controls (HCs).
  
  
  METHODS
  In this observational cross-sectional study at two German academic MS centres, RNFLT and TMV were measured by spectral-domain optical coherence tomography in 32 HCs, 36 EOMS (mean age at onset 15.5 ± 2.0 years) and 58 LOMS patients.
  
  
  RESULTS
  In comparison with HCs, EOMS patients displayed a significant reduction of RNFLT and TMV independently of a history of optic neuritis. In particular, RNFLT loss in EOMS was similar to that in LOMS and TMV loss was slightly higher compared with disease-duration-matched LOMS. In a generalized estimating model, the EOMS group also displayed a similar correlation between disease duration and RNFLT or TMV loss to LOMS patients.
  
  
  CONCLUSIONS
  These data argue for a significant amount of axonal and neuronal damage in the retina of EOMS patients and may provide a structural basis for the observation that EOMS patients reach states of irreversible disability at a younger age than patients with LOMS.
authors.affiliation: Department of Neurology, University of Erlangen, Erlangen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Huhn
authors.forename: R
authors.initials: R
authors.lastname: Lämmer
authors.forename: T
authors.initials: T
authors.lastname: Oberwahrenbrock
authors.forename: A
authors.initials: A
authors.lastname: Lämmer
authors.forename: A
authors.initials: A
authors.lastname: Waschbisch
authors.forename: D
authors.initials: D
authors.lastname: Gosar
authors.forename: A
authors.initials: A
authors.lastname: Brandt
authors.forename: F
authors.initials: F
authors.lastname: Paul
authors.forename: R A
authors.initials: RA
authors.lastname: Linker
authors.forename: D-H
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000328:Adult; D017668:Age of Onset; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D009412:Nerve Fibers / Q000473:pathology; D012160:Retina / Q000473:pathology*; D055351:Retinal Neurons / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: multiple sclerosis; neuroophthalmology; paediatric neurology