Optical coherence tomography in acute optic neuritis: A population-based study

Kerstin Soelberg; Svenja Specovius; Hanna G. Zimmermann; Jakob Grauslund; Jesper J. Mehlsen; Clement Olesen; Allan S.B. Neve; Friedemann Paul; Alexander U. Brandt; Nasrin Asgari

doi:10.1111/ane.13004

Optical coherence tomography in acute optic neuritis: A population-based study

Kerstin Soelberg
, Svenja Specovius
, Hanna G. Zimmermann
, Jakob Grauslund
, Jesper J. Mehlsen
, Clement Olesen
, Allan S.B. Neve
, Friedemann Paul
, Alexander U. Brandt
, Nasrin Asgari^*

^*Corresponding author for this work

Medicine (NSR)

Research output: Contribution to journal › Article › Research › peer-review

Abstract

Objectives: To measure early structural damage caused by autoimmune inflammatory optic neuritis (ON) by optical coherence tomography (OCT) in a population-based cohort. Methods: In a prospective population-based study over 24 months in Southern Denmark, patients diagnosed with acute ON and without prior diagnosis of a chronic neuroinflammatory disorder were included and examined with OCT, visual evoked potentials (VEP), visual fields, high contrast visual acuity (HCVA), and low contrast letter acuity (LCLA). Structural and functional outcomes were determined at 6-month follow-up based on interocular differences. Results: The 50 included patients had on average 16.9 μm peripapillary retinal nerve fiber layer loss, 10.6 μm ganglion cell and inner plexiform layer (GCIP) loss, and an average HCVA decrease of 0.22 dec. Based on a linear regression model, average GCIP loss amounted to −0.2 μm per day and started 8 days after onset. OCT outcomes but not VEP correlated well with all visual function measurements at follow-up. Structural and functional damage in 20 patients (40%) diagnosed de novo with multiple sclerosis (MS) and in 2 patients (4%) with positive myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) test did not differ from patients with idiopathic ON. Conclusions: Optic neuritis causes substantial retinal damage and vision loss independent of the underlying disease. Our study supports that GCIP damage starts closely to clinical onset. Good structure-function correlations between OCT and vision support the importance of OCT in monitoring acute ON.

Original language	English
Pages (from-to)	566-573
Number of pages	8
Journal	Acta Neurologica Scandinavica
Volume	138
Issue number	6
DOIs	https://doi.org/10.1111/ane.13004
Publication status	Published - Dec 2018

Funding

The study was supported by the Region of Southern Denmark, the University of Southern Denmark, the Danish Multiple Sclerosis Society, and Lillebaelt Research Foundation. The authors thank Kevin K. Mortensen, MD, Carsten Bisgaard, MD, Malou Høgsbro, MD, Gerda Nørrelykke Møller, MD, and Alan Kimper-Karl, MD, for creating facilities for patient investigation. The authors thank the department of Neurology and Neurophysiology at Lillebaelt Hospital, in particular Louise B Jensen, RN and Grethe G Isaksen, RN, the three departments of ophthalmology, and all the ophthalmologist in general practice in the Region of Southern Denmark; The data manager David Hass is thanked for establishing the REDCap database; Michael Zahle from Eye Optic is thanked for establishing the OCT protocol on the OCT machine and continuously support. The authors thank the following for foundation supported: Region of Southern Denmark, The University of Southern Denmark, the Danish Multiple Sclerosis Society, Lillebaelt Research Foundation, and Director Jakob Madsen and Wife Olga Madsen’s foundation.

Keywords

autoimmune diseases
multiple sclerosis
myelin oligodendrocyte glycoprotein autoantibodies
optic neuritis
optical coherence tomography

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10.1111/ane.13004

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@article{39681514de7643219f58e829f6190c75,

title = "Optical coherence tomography in acute optic neuritis: A population-based study",

abstract = "Objectives: To measure early structural damage caused by autoimmune inflammatory optic neuritis (ON) by optical coherence tomography (OCT) in a population-based cohort. Methods: In a prospective population-based study over 24 months in Southern Denmark, patients diagnosed with acute ON and without prior diagnosis of a chronic neuroinflammatory disorder were included and examined with OCT, visual evoked potentials (VEP), visual fields, high contrast visual acuity (HCVA), and low contrast letter acuity (LCLA). Structural and functional outcomes were determined at 6-month follow-up based on interocular differences. Results: The 50 included patients had on average 16.9 μm peripapillary retinal nerve fiber layer loss, 10.6 μm ganglion cell and inner plexiform layer (GCIP) loss, and an average HCVA decrease of 0.22 dec. Based on a linear regression model, average GCIP loss amounted to −0.2 μm per day and started 8 days after onset. OCT outcomes but not VEP correlated well with all visual function measurements at follow-up. Structural and functional damage in 20 patients (40\%) diagnosed de novo with multiple sclerosis (MS) and in 2 patients (4\%) with positive myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) test did not differ from patients with idiopathic ON. Conclusions: Optic neuritis causes substantial retinal damage and vision loss independent of the underlying disease. Our study supports that GCIP damage starts closely to clinical onset. Good structure-function correlations between OCT and vision support the importance of OCT in monitoring acute ON.",

keywords = "autoimmune diseases, multiple sclerosis, myelin oligodendrocyte glycoprotein autoantibodies, optic neuritis, optical coherence tomography",

author = "Kerstin Soelberg and Svenja Specovius and Zimmermann, \{Hanna G.\} and Jakob Grauslund and Mehlsen, \{Jesper J.\} and Clement Olesen and Neve, \{Allan S.B.\} and Friedemann Paul and Brandt, \{Alexander U.\} and Nasrin Asgari",

year = "2018",

month = dec,

doi = "10.1111/ane.13004",

language = "English",

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T1 - Optical coherence tomography in acute optic neuritis

T2 - A population-based study

AU - Soelberg, Kerstin

AU - Specovius, Svenja

AU - Zimmermann, Hanna G.

AU - Grauslund, Jakob

AU - Mehlsen, Jesper J.

AU - Olesen, Clement

AU - Neve, Allan S.B.

AU - Paul, Friedemann

AU - Brandt, Alexander U.

AU - Asgari, Nasrin

PY - 2018/12

Y1 - 2018/12

N2 - Objectives: To measure early structural damage caused by autoimmune inflammatory optic neuritis (ON) by optical coherence tomography (OCT) in a population-based cohort. Methods: In a prospective population-based study over 24 months in Southern Denmark, patients diagnosed with acute ON and without prior diagnosis of a chronic neuroinflammatory disorder were included and examined with OCT, visual evoked potentials (VEP), visual fields, high contrast visual acuity (HCVA), and low contrast letter acuity (LCLA). Structural and functional outcomes were determined at 6-month follow-up based on interocular differences. Results: The 50 included patients had on average 16.9 μm peripapillary retinal nerve fiber layer loss, 10.6 μm ganglion cell and inner plexiform layer (GCIP) loss, and an average HCVA decrease of 0.22 dec. Based on a linear regression model, average GCIP loss amounted to −0.2 μm per day and started 8 days after onset. OCT outcomes but not VEP correlated well with all visual function measurements at follow-up. Structural and functional damage in 20 patients (40%) diagnosed de novo with multiple sclerosis (MS) and in 2 patients (4%) with positive myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) test did not differ from patients with idiopathic ON. Conclusions: Optic neuritis causes substantial retinal damage and vision loss independent of the underlying disease. Our study supports that GCIP damage starts closely to clinical onset. Good structure-function correlations between OCT and vision support the importance of OCT in monitoring acute ON.

AB - Objectives: To measure early structural damage caused by autoimmune inflammatory optic neuritis (ON) by optical coherence tomography (OCT) in a population-based cohort. Methods: In a prospective population-based study over 24 months in Southern Denmark, patients diagnosed with acute ON and without prior diagnosis of a chronic neuroinflammatory disorder were included and examined with OCT, visual evoked potentials (VEP), visual fields, high contrast visual acuity (HCVA), and low contrast letter acuity (LCLA). Structural and functional outcomes were determined at 6-month follow-up based on interocular differences. Results: The 50 included patients had on average 16.9 μm peripapillary retinal nerve fiber layer loss, 10.6 μm ganglion cell and inner plexiform layer (GCIP) loss, and an average HCVA decrease of 0.22 dec. Based on a linear regression model, average GCIP loss amounted to −0.2 μm per day and started 8 days after onset. OCT outcomes but not VEP correlated well with all visual function measurements at follow-up. Structural and functional damage in 20 patients (40%) diagnosed de novo with multiple sclerosis (MS) and in 2 patients (4%) with positive myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) test did not differ from patients with idiopathic ON. Conclusions: Optic neuritis causes substantial retinal damage and vision loss independent of the underlying disease. Our study supports that GCIP damage starts closely to clinical onset. Good structure-function correlations between OCT and vision support the importance of OCT in monitoring acute ON.

KW - autoimmune diseases

KW - multiple sclerosis

KW - myelin oligodendrocyte glycoprotein autoantibodies

KW - optic neuritis

KW - optical coherence tomography

UR - https://www.scopus.com/pages/publications/85052446195

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JO - Acta Neurologica Scandinavica

JF - Acta Neurologica Scandinavica

IS - 6

ER -

Optical coherence tomography in acute optic neuritis: A population-based study

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