title: Optic radiation damage in multiple sclerosis is associated with visual dysfunction and retinal thinning--an ultrahigh-field MR pilot study.
abstract: OBJECTIVE
  To investigate posterior visual pathway damage in multiple sclerosis using ultrahigh-field magnetic resonance imaging (MRI) at 7 Tesla (7 T), and to determine its correlation with visual disability and retinal fibre layer (RNFL) damage detectable by optic coherence tomography (OCT).
  
  
  METHODS
  We studied 7 T MRI, OCT, functional acuity contrast testing (FACT), and visually evoked potentials (VEP, n = 16) in 30 patients (including 26 relapsing-remitting MS and four clinically isolated syndrome patients) and 12 healthy controls to quantify RNFL thickness, optic radiation lesion volume, and optic radiation thickness.
  
  
  RESULTS
  Optic radiation lesion volume was associated with thinning of the optic radiation (p < 0.001), delayed VEP (p = 0.031), and visual disability indicated by FACT (p = 0.020). Furthermore, we observed an inverse correlation between optic radiation lesion volume and RNFL thickness (p < 0.001), including patients without previous optic neuritis (p < 0.001).
  
  
  CONCLUSIONS
  Anterior visual pathway damage, but also (subclinical) optic radiation integrity loss detectable by 7 T MRI are common findings in MS that are mutually affected. Given the association between optic radiation damage, visual impairment, and increased VEP latency in this exploratory study of a limited sample size, clinicians should be aware of acute lesions within the optic radiation in patients with (bilateral) visual disturbances.
  
  
  CONCLUSIONS
  • Focal destruction of the optic radiation is detectable by 7 T MRI. • Focal optic radiation damage is common in MS. • Optic radiation damage is associated with RNFL thinning, detectable by OCT. • Optic radiation damage is associated with delayed VEP and visual dysfunction. • RNFL thickness in non-optic neuritis eyes correlates with optic radiation demyelination.
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitaetsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Sinnecker
authors.forename: Timm
authors.initials: T
authors.lastname: Oberwahrenbrock
authors.forename: Imke
authors.initials: I
authors.lastname: Metz
authors.forename: Hanna
authors.initials: H
authors.lastname: Zimmermann
authors.forename: Caspar F
authors.initials: CF
authors.lastname: Pfueller
authors.forename: Lutz
authors.initials: L
authors.lastname: Harms
authors.forename: Klemens
authors.initials: K
authors.lastname: Ruprecht
authors.forename: Caren
authors.initials: C
authors.lastname: Ramien
authors.forename: Katrin
authors.initials: K
authors.lastname: Hahn
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Brück
authors.forename: Thoralf
authors.initials: T
authors.lastname: Niendorf
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
authors.forename: Alexander U
authors.initials: AU
authors.lastname: Brandt
authors.forename: Jan
authors.initials: J
authors.lastname: Dörr
authors.forename: Jens
authors.initials: J
authors.lastname: Wuerfel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D009412:Nerve Fibers / Q000473:pathology; D009801:Oculomotor Muscles / Q000473:pathology; D009902:Optic Neuritis / Q000473:pathology*; D010865:Pilot Projects; D011446:Prospective Studies; D012164:Retinal Diseases / Q000473:pathology; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000209:etiology* / Q000473:pathology; D055815:Young Adult