Optic Neuritis Is Associated with Inner Nuclear Layer Thickening and Microcystic Macular Edema Independently of Multiple SclerosisReportar como inadecuado

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Microcystic macular edema MME and inner nuclear layer thickening INL were described in multiple sclerosis MS and neuromyelitis optica NMO patients using optical coherence tomography OCT. The cause of these findings is currently unknown and a relation to inflammatory or degenerative processes in the optic nerve is discussed.


The aim of our study was to investigate whether INL thickening and MME are related to optic neuritis ON in various neuro-inflammatory disorders causingON: MS, NMO and chronic inflammatory optic neuropathy.


We retrospectively analyzed data from 216 MS patients, 39 patients with a clinically isolated syndrome, 20 NMO spectrum disorder patients, 9 patients with chronic inflammatory optic neuropathy and 121 healthy subjects. Intra-retinal layer segmentation was performed for the eyes of patients with unilateral ON. Scanning laser ophthalmoscopy SLO images were reviewed for characteristic ocular fundus changes.


Intra-retinal layer segmentation showed that eyes with a history of ON displayed MME independent INL thickening compared to contralateral eyes without previous ON. MME was detected in 22 eyes from 15 patients 5.3% of all screened patients, including 7 patients with bilateral edema. Of these, 21 had a prior history of ON 95%. The SLO images of all 22 MME-affected eyes showed crescent-shaped texture changes which were visible in the perifoveal region. A second grader who was blinded to the results of the OCT classified all SLO images for the presence of these characteristic fundus changes. All MME eyes were correctly classified sensitivity = 100% with high specificity 95.2%.


This study shows that both MME and INL thickening occur in various neuro-inflammatory disorders associated with ON. We also demonstrate that detection and analysis of MME by OCT is not limited to B-scans, but also possible using SLO images.

Autor: Falko Kaufhold, Hanna Zimmermann, Elisa Schneider, Klemens Ruprecht, Friedemann Paul , Timm Oberwahrenbrock , Alexander U. Brandt

Fuente: http://plos.srce.hr/


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