Retinal axonal loss in very early stages of multiple sclerosis.
OBJECTIVE
The lack of surrogates of clinical progression has limited the design of neuroprotection trials in multiple sclerosis (MS). Our aim was to study the association between time-domain optical coherence tomography measures and clinical and magnetic resonance imaging outcomes in early MS.


METHODS
Forty-three relapsing-remitting MS patients within 1 year of onset were followed for up to 3 years.


RESULTS
The peripapillary retinal nerve fiber layer (RNFL) decreased annually by 2 μm (95% confidence interval -3.89, -0.11; P = 0.038). The RNFL tended to be associated with normalized normal appearing white matter volume in cross-sectional (P = 0.08) and longitudinal analyses (P = 0.06).


CONCLUSIONS
There is substantial RNFL loss even in very early MS. Our data suggest that retinal axonal atrophy is associated with atrophy in global white matter volume in early MS.
Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
A-H
AH
Maghzi
Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
J
J
Graves
Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
N
N
Revirajan
Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
R
R
Spain
Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
S
S
Liu
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
C E
CE
McCulloch
Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
D
D
Pelletier
Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
A J
AJ
Green
Department of Neurology, University of California San Francisco, San Francisco, CA, USA.|Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
E
E
Waubant
D000328:Adult; D001284:Atrophy / Q000473:pathology; D001369:Axons / Q000473:pathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000150:complications; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D016032:Randomized Controlled Trials as Topic; D055351:Retinal Neurons / Q000473:pathology*; D041623:Tomography, Optical Coherence; D066127:White Matter / Q000473:pathology
magnetic resonance imaging; multiple sclerosis; neuroprotection; optical coherence tomography