title: Optical coherence tomography indicates disease activity prior to clinical onset of central nervous system demyelination.
abstract: Establishing biomarkers for predicting disease activity in demyelinating disease of the central nervous system is crucial for designing appropriate disease modifiying treatment strategies.
  
  
  
  To investigate retinal findings and disease activity in patients with radiologically isolated and clinically isolated syndromes.
  
  
  
  We performed retinal optical coherence tomography and cerebral magnetic resonance imaging in healthy control individuals (n=19), in individuals with non-specific white matter lesions (n=18), and in patients with clinically isolated syndromes (n=18) and radiologically isolated syndromes (n=20).
  
  
  
  Reduced volume of retinal nerve fibre layer and increased volume of inner nuclear layer at baseline correlated with subsequent disease activity as measured by an increase in cerebral T2 lesion load in patients with radiologically isolated syndromes. Reduced volume of retinal nerve fibre layer and increased volumes of inner and outer nuclear layer were associated with progression into multiple sclerosis in patients with clinically isolated syndromes.
  
  
  
  Patients with radiologically and clinically isolated syndromes behave similarly concerning paraclinical disease activity in cerebral magnetic resonance imaging. In both conditions, reduction of retinal nerve fibre layer and increased inner nuclear layer and outer nuclear layer volumes predict disease activity and are associated with progression into multiple sclerosis.
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Knier
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Berthele
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Buck
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany/Department of Statistics, Ludwig-Maximilians-Universität München, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Schmidt
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany/Munich Cluster for Systems Neurology (SyNergy), Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Mühlau
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany/Munich Cluster for Systems Neurology (SyNergy), Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hemmer
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany/Munich Cluster for Systems Neurology (SyNergy), Germany thomas.korn@tum.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Korn
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003711:Demyelinating Diseases / Q000000981:diagnostic imaging*; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D012160:Retina / Q000000981:diagnostic imaging*; D041623:Tomography, Optical Coherence
keywords: Multiple sclerosis; disease progression; inner nuclear layer; magnetic resonance imaging; optical coherence tomography; radiologically isolated syndrome