Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis

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Abstract

Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MSâ 'ON). MSâ 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.

Original languageEnglish (US)
Pages (from-to)520-524
Number of pages5
JournalBritish Journal of Ophthalmology
Volume102
Issue number4
DOIs
StatePublished - Apr 1 2018

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Optical Coherence Tomography
Optic Nerve
Multiple Sclerosis
Optic Neuritis
Angiography
Optic Disk
Nerve Fibers
ROC Curve
Ganglia
Perfusion
Logistic Models

Keywords

  • multiple sclerosis
  • OCT angiography
  • optic neuritis
  • optical coherence tomography
  • retina

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

@article{74d29332d2274fe5a90fbbb902f2a2c4,
title = "Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis",
abstract = "Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MS{\^a} 'ON). MS{\^a} 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.",
keywords = "multiple sclerosis, OCT angiography, optic neuritis, optical coherence tomography, retina",
author = "Rebecca Spain and Liang Liu and Xinbo Zhang and Jia Yali and Ou Tan and Dennis Bourdette and David Huang",
year = "2018",
month = "4",
day = "1",
doi = "10.1136/bjophthalmol-2017-310477",
language = "English (US)",
volume = "102",
pages = "520--524",
journal = "British Journal of Ophthalmology",
issn = "0007-1161",
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TY - JOUR

T1 - Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis

AU - Spain, Rebecca

AU - Liu, Liang

AU - Zhang, Xinbo

AU - Yali, Jia

AU - Tan, Ou

AU - Bourdette, Dennis

AU - Huang, David

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MSâ 'ON). MSâ 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.

AB - Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MSâ 'ON). MSâ 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.

KW - multiple sclerosis

KW - OCT angiography

KW - optic neuritis

KW - optical coherence tomography

KW - retina

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