title: Subtle retinal pathology in amyotrophic lateral sclerosis.
abstract: Amyotrophic lateral sclerosis (ALS) is characterized by neuro-ophthalmological abnormalities beyond disturbed oculomotor control such as decreased visual acuity and disturbed visual evoked potentials. Here we report retinal alterations in a cohort of 24 patients with clinically definite (n = 20) or probable (n = 4) ALS as compared to matched controls. High-resolution spectral domain optical coherence tomography with retinal segmentation revealed a subtle reduction in the macular thickness and the retinal nerve fiber layer (RNFL) as well as a marked thinning of the inner nuclear layer (INL). Our data indicate an unprecedented retinal damage pattern and suggest neurodegeneration beyond the motor system in this disease.
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Marius
authors.initials: M
authors.lastname: Ringelstein
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Albrecht
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany ; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Südmeyer
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Harmel
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Ann-Kristin
authors.initials: AK
authors.lastname: Müller
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Nazmiye
authors.initials: N
authors.lastname: Keser
authors.affiliation: Department of Ophthalmology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Finis
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany ; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrea
authors.affiliation: Department of Ophthalmology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Guthoff
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany ; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Alfons
authors.initials: A
authors.lastname: Schnitzler
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany ; Department of Neurology, Medical Faculty, Johannes Gutenberg University Mainz, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Methner
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
authors.forename: Orhan
authors.initials: O
authors.lastname: Aktas