Abstract

SA.15.05

Measurement of retinal nerve fiber layer thickness with the Spectralis high resolution OCT in acute and recovered optic neuritis associated with multiple sclerosis or neuromyeltits optica

Nermin Serbecic1, Sven Beutelspacher2, Karl Kircher1, Ursula Schmidt-Erfurth1, Andreas Reitner1
1Universitätsklinik für Augenheilkunde und Optometrie, Medizinische Universität Wien, Wien, Austria, 2Universitäts-Augenklinik Mannheim

Objective
we are describing for the first time the clinical value of high-resolution (HR-) OCT in the diagnostic workup process of acute and recovered optic neuritis (ON) in patients with clinically definite Multiple sclerosis (MS) and Neuromyelitis optica (NMO).
Methods
19 MS patients (27 eyes, 17f and 3m) with acute (14 eyes) or recovered (13 eyes) ON and one NMO patient with bilateral acute ON underwent a series of high-resolution OCT (Spectralis, HRA-OCT, Heidelberg Engineering) examinations of the peripapillary retinal nerve fiber layer (RNFL) thickness.
Results
In MS patients with acute ON 1. normal range RNFL values in micrometer (right eye=RA/left eye=LA) as obtained from age and sex-matched controls were detected in 8 eyes (94/80; 115/85; 116/111; 88/87; 113/107; 82/109; 94/64; 102/89) and both eyes in acute stage of NMO (95/95); axonal swelling was found in 3 eyes (148/106; 158/117; 128/111) whereas RNFL reduction was measured in 3 eyes (85/98; 96/84; 80/90).
In 12 out of 13 eyes of MS patients with recovered ON axonal thinning (102/89; 115/85; 94/80; 82/109) or global/sectorial atrophy (70/67; 60/61; 75/50; 94/64; 98/62) was measured. Only one eye presented with normal range RNFL values (98/102)
Conclusions
In early stages of ON axonal swelling measured by HR-OCT is strictly correlated to discrete but ophthalmoscopically visible optic disc swelling. No alteration of the RNFL was observed in acute NNO with normal optic disc morphology. RNFL reduction and/or atrophy was found in nearly all eyes following NNO recovery independently of the functional outcome. These results can be used as an additional valuable tool in the diagnostic neuroophthalomologic workup of ON.

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