Exploring the Association between Retinal Nerve Fiber Layer Thickness and Initial Magnetic Resonance Imaging Findings in Patients with Acute Optic Neuritis

Fiona Costello,William Hodge,Y Irene Pan

doi:10.1155/2011/289785

Abstract

Background. Recent studies have shown that OCT-measured retinal nerve fiber layer (RNFL) values may represent a marker for axonal damage in the anterior visual pathway of optic neuritis (ON) and multiple sclerosis (MS) patients. The goal of this study was to determine the link between RNFL values and initial magnetic resonance imaging (MRI) evidence of central nervous system (CNS) inflammation in patients with acute ON. Methods. Fifty patients who experienced ON as a clinically isolated syndrome (CIS) were followed for a mean period of 34 months with OCT testing. RNFL values in affected (ON) eyes and clinically unaffected (non-ON) eyes were compared between patients with MRI evidence of white matter lesions and those with normal baseline MRI findings, over a two year period. Findings. Twenty-one patients (42%) developed clinically definite MS (CDMS) during the study. After two years, temporal RNFL values were thinner (P = .07) in ON patients with MRI lesions at baseline, but the results were not significant. Conclusions. There is no association between RNFL values and baseline MRI status in ON patients at risk for future CDMS over a two year period.

Highlights

Optic neuritis (ON) is an inflammatory optic nerve injury, which is strongly associated with multiple sclerosis (MS) [1,2,3,4,5,6,7,8,9,10,11]
Twenty-one patients (42%) developed clinically definite MS (CDMS) during the course of the study, with a mean conversion time of 27 months
We observed no association between the presence of clinically silent lesions on baseline magnetic resonance imaging (MRI) and retinal nerve fiber layer (RNFL) thickness in clinically isolated syndrome (CIS) patients followed for two years after an acute optic neuritis (ON) event

Summary

Introduction

Optic neuritis (ON) is an inflammatory optic nerve injury, which is strongly associated with multiple sclerosis (MS) [1,2,3,4,5,6,7,8,9,10,11]. The longitudinal followup from the optic neuritis treatment trial [3] (ONTT) demonstrated that the initial magnetic resonance imaging (MRI) study is the most potent predictor for future MS after acute ON: such that evidence of disseminated central nervous system (CNS) inflammation on baseline MRI increases the risk for future clinically definite MS (CDMS) after acute ON [4,5,6]. After 15 years 72% of ON patients with one or more white matter lesions on their initial MRI developed CDMS, as compared to 25% of patients with no MRI lesions [6]. RNFL values in affected (ON) eyes and clinically unaffected (non-ON) eyes were compared between patients with MRI evidence of white matter lesions and those with normal baseline MRI findings, over a two year period. There is no association between RNFL values and baseline MRI status in ON patients at risk for future CDMS over a two year period

Objectives

Methods

Conclusion