title: Subclinical primary retinal pathology in neuromyelitis optica spectrum disorder.
abstract: Foveal thickness may be a more sensitive indicator of primary retinal pathology than retinal nerve fiber layer thickness since the fovea contains no or sparse retinal nerve fiber layer, which coalesces into axons of the optic nerve. To our knowledge, few quantitative in vivo studies have investigated foveal thickness. By using optical coherence tomography, we measured foveal thickness to evaluate intrinsic retinal pathology. Seventy-two neuromyelitis optica spectrum disorder patients (99 eyes with optic neuritis and 45 eyes without optic neuritis) and 34 age-matched controls were included. Foveal thinning was observed both in eyes with non-optic neuritis (185.1 µm, p < 0.001) and optic neuritis (185.0 µm, p < 0.001) relative to controls (205.0 µm). Compared to controls, eyes with non-optic neuritis did not have peripapillary retinal nerve fiber layer thinning, but showed foveal thinning (p < 0.001). In neuromyelitis optica spectrum disorder, foveal thickness correlated with 2.5 % low contrast visual acuity, while retinal nerve fiber layer thickness correlated with high or low contrast visual acuity, extended disability status scale, and disease duration. In this study, we observed foveal thinning irrespective of optic neuritis; thus, we believe that subclinical primary retinal pathology, prior to retinal nerve fiber layer thinning, may exist in neuromyelitis optica spectrum disorder.
authors.affiliation: Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
authors.forename: In Hye
authors.initials: IH
authors.lastname: Jeong
authors.affiliation: Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
authors.forename: Ho Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Dongguk University Ilsan Hospital, 27 Donggukro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-773, South Korea. nheekim8@hanmail.net.
authors.forename: Nam-Hee
authors.initials: NH
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Kyoung Sook
authors.initials: KS
authors.lastname: Jeong
authors.affiliation: Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Choul Yong
authors.initials: CY
authors.lastname: Park
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood; D051401:Aquaporin 4 / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009471:Neuromyelitis Optica / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology*; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014795:Visual Pathways / Q000000981:diagnostic imaging
chemical_list: D000906:Antibodies; D051401:Aquaporin 4
keywords: Fovea thickness; Neuromyelitis optica spectrum disorder; Optical coherence tomography