Abstract
We thank Dr. Avasarala for his comments on our editorial regarding the corresponding study by Xu et al.,1,2 in which the sensitivity of optical coherence tomography (OCT) measures for detecting previous optic neuritis (ON) was examined. Although Naismith et al. reported that OCT was less sensitive than visual evoked potentials (VEP) in detecting previous ON,3 this study used older third-generation time domain OCT. Undoubtedly, the greatest advance in OCT in the past decade has been the development of fourth-generation spectral domain OCT. Current commercially available spectral domain OCT has extremely high resolution (3–5 μm). Moreover, peripapillary retinal nerve fiber layer (RNFL) and composite ganglion cell and inner plexiform layer (GCIPL) thicknesses have excellent reliability and reproducibility, with the intervisit intraclass correlation coefficient for GCIPL thickness being 0.99.4 Furthermore, OCT measures provide invaluable information regarding the global multiple sclerosis (MS) disease process, including mirroring brain atrophy, disease activity, predicting future disability, and conversion to clinically definite MS.5
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