RT Journal Article
SR Electronic
T1 Dynamics of Retinal Vessel Loss After Acute Optic Neuritis in Patients With Relapsing Multiple Sclerosis
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e1159
DO 10.1212/NXI.0000000000001159
VO 9
IS 3
A1 Aly, Lilian
A1 Noll, Christina
A1 Wicklein, Rebecca
A1 Wolf, Elisabeth
A1 Romahn, Eva Feodora
A1 Wauschkuhn, Josphine
A1 Hosari, Sami
A1 Mardin, Christian
A1 Berthele, Achim
A1 Hemmer, Bernhard
A1 Korn, Thomas
A1 Knier, Benjamin
YR 2022
UL http://nn.neurology.org/content/9/3/e1159.abstract
AB Background and Objectives Rarefication of the retinal vasculature as measured by optical coherence tomography angiography (OCT-A) is a novel finding in patients with multiple sclerosis (MS). This study aimed to analyze longitudinal dynamics of the retinal vasculature following an acute inflammatory relapse including acute optic neuritis (ON) and to search for associations with alterations of the retinal architecture and visual function.Methods This prospective longitudinal cohort study included patients with relapsing-remitting MS or clinically isolated syndrome having an acute ON (n = 20) or a non-ON relapse (n = 33). Patients underwent examinations at baseline and after 7, 14, 28, 90, and 180 days with OCT, OCT-A, and assessment of the high- (HCVA) and low-contrast visual acuity (LCVA).Results Retinal vessel loss of the superficial vascular complex (SVC) evolves early after ON and reaches a plateau between 90 and 180 days (relative vessel loss 15% ± 8% [mean ± SD]). In addition, an 18% ± 18% intraindividual increase of the foveal avascular zone (FAZ) is evident within 180 days after acute ON. Both SVC thinning and FAZ enlargement were associated with worse HCVA and LCVA. Rarefication of the SVC evolved simultaneously to thinning of the common ganglion cell and inner plexiform layer (GCIP) after ON. No alterations of the deep vascular complex were seen in eyes with ON, and no alterations of the retinal vasculature were recognized in patients having acute non-ON relapses.Discussion Rarefication of the SVC and growing of the FAZ evolve rapidly after ON and are linked to persistent visual disability. ON-related SVC thinning might be closely linked to GCIP atrophy and might occur due to an altered local metabolic activity within inner retinal layers.CIS=clinically isolated syndrome; DVC=deep vascular complex; EDSS=Expanded Disability Status Scale; FAZ=foveal avascular zone; GCIP=ganglion cell and inner plexiform layer; HCVA=high-contrast visual acuity; INL=inner nuclear layer; LCVA=low-contrast visual acuity; MS=multiple sclerosis; OCT=optical coherence tomography; OCT-A=OCT angiography; ON=optic neuritis; OPL + ONL=combined outer plexiform and outer nuclear layer; pRNFL=peripapillary RNFL; RNFL=retinal nerve fiber layer; RRMS=relapsing-remitting MS; SVC=superficial vascular complex