MS optic neuritis-induced long-term structural changes within the visual pathway. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Pawlitzki, Marc; Horbrügger, Marc; Loewe, Kristian; Kaufmann, Jörn; Opfer, Roland; Wagner, Markus; Al-Nosairy, Khaldoon O.; Meuth, Sven G.; Hoffmann, Michael B.; Schippling, Sven
• Is Part Of: Neurology. Volume 7:Issue 2(2020)
• Publication Date: 2020-03
• Subjects: Neuroimmunology -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1212/NXI.0000000000000665
• Languages: English
• ISSNs: 2332-7812

Abstract

Abstract : Background: The visual pathway is commonly involved in multiple sclerosis (MS), even in its early stages, including clinical episodes of optic neuritis (ON). The long-term structural damage within the visual compartment in patients with ON, however, is yet to be elucidated. Objective: Our aim was to characterize visual system structure abnormalities using MRI along with optical coherence tomography (OCT) and pattern-reversal visual evoked potentials (VEPs) depending on a single history of ON. Methods: Twenty-eight patients with clinically definitive MS, either with a history of a single ON (HON) or without such history and normal VEP findings (NON), were included. OCT measures comprised OCT-derived peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell/inner plexiform layer (GCIPL) thickness. Cortical and global gray and white matter, thalamic, and T2 lesion volumes were assessed using structural MRI. Diffusion-weighted MRI-derived measures included fractional anisotropy (FA), mean (MD), radial (RD), and axial (AD) diffusivity within the optic radiation (OR). Results: Mean (SD) duration after ON was 8.3 (3.7) years. Compared with the NON group, HON patients showed significant RNFL ( p = 0.01) and GCIPL thinning ( p = 0.002). OR FA ( p = 0.014), MD ( p = 0.005), RD ( p = 0.007), and AD ( p = 0.004) were altered compared with NON. Global gray and white as well as other regional gray matter structures did not differ between the 2 groups. Conclusion: A single history of ON induces long-term structural damage within the retina and OR suggestive of both retrograde and anterograde neuroaxonal degeneration.