title: Retinal imaging and axonal degeneration in later onset multiple sclerosis.
abstract: BACKGROUND
  Multiple Sclerosis (MS) is a chronic inflammatory disease of the CNS typically affecting younger adults and resulting in neuro-axonal degeneration already at early stages of the disease. Less is known about the effects of a later disease onset (LOMS, onset >50years of age). Analysis of retinal layers by optical coherence tomography (OCT) is a non-invasive method to investigate retinal and neuro-axonal degeneration. We applied OCT to detect differences in retinal damage depending on a later disease manifestation.
  
  
  METHODS
  14 LOMS patients, 14 age- and 14 disease duration-matched normal onset (NOMS) patients with a relapsing remitting disease course and 15 healthy controls (HC) were included. OCT measurement of peripapillary retinal nerve fiber layer (RNFL), total macular volume (TMV), combined ganglion cell/inner plexiform layer (GCIPL), inner nuclear layer (INL) and outer retinal layers (ORL) was conducted. Furthermore, analysis of clinical features and of effects of previous optic neuritis (ON) was performed RESULTS: In a GEE based analysis of age- and disease duration matched NOMS, LOMS patients show no significant differences in retinal layer thickness whereas ON significantly reduced thickness of retinal layers. All MS groups display lower retinal layer thickness as compared to HC independently of type of onset.
  
  
  CONCLUSIONS
  Our LOMS findings are well in line with published OCT data of normal onset MS. As the degree of retinal layer thinning was similar in MS subgroups, retinal neurodegeneration in MS may occur independently of time of disease onset.
authors: Department of Neurology, University of Erlangen, Germany. Electronic address: Konstantin.Huhn@uk-erlangen.de.
authors: Konstantin
authors: K
authors: Huhn
authors: Department of Ophthalmology, University of Erlangen, Germany.
authors: Robert
authors: R
authors: Lämmer
authors: NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité Universitätsmedizin Berlin, Germany.
authors: Hanna
authors: H
authors: Zimmermann
authors: Department of Neurology, University of Erlangen, Germany.
authors: Alexandra
authors: A
authors: Lämmer
authors: Department of Neurology, University of Erlangen, Germany.
authors: Anne
authors: A
authors: Waschbisch
authors: Department of Neurology, University of Erlangen, Germany.
authors: Kathrin
authors: K
authors: Utz
authors: NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité Universitätsmedizin Berlin, Germany.
authors: René Markus
authors: RM
authors: Gieß
authors: NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité Universitätsmedizin Berlin, Germany.
authors: Friedemann
authors: F
authors: Paul
authors: Department of Neurology, University of Erlangen, Germany.
authors: Ralf A
authors: RA
authors: Linker
authors: Department of Neurology, University of Erlangen, Germany.
authors: De-Hyung
authors: DH
authors: Lee
mesh_terms: D000328:Adult; D017668:Age of Onset; D001369:Axons; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012160:Retina / Q000000981:diagnostic imaging*; D012162:Retinal Degeneration / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D015415:Biomarkers
keywords: Late onset multiple sclerosis; Neuroophthalmology; Optical coherence tomography