Highlights
- •OCT can differentiate definite NMOSD from patients suspected of NMOSD but not fulfilling the diagnostic criteria.
- •Retinal layer measures by OCT in patients with possible NMOSD are similar to those in definite NMOSD.
- •Retinal layer measures by OCT in possible NMOSD are lower than in MS and healthy controls.
- •OCT could be a valuable addition to the current consensus diagnostic criteria of NMOSD.
Abstract
Background
Retinal optical coherence tomography (OCT) can differentiate definite NMOSD (dNMOSD)
from multiple sclerosis (MS), but has not been evaluated in patients with a high clinical
suspicion of NMOSD and not fulfilling the current consensus diagnostic criteria, referred
in this paper as “potential” NMOSD (pNMOSD).
Aim
To compare the retinal OCT measurements between patients with pNMOSD, dNMOSD, MS,
and reference healthy controls (HC).
Material and methods
In this cross-sectional study, clinical and demographic characteristics, as well as
OCT measurements of peripapillary retinal nerve fiber layer (pRNFL), inner nuclear
layer (INL), macular retinal nerve fiber layer (mRNFL), outer nuclear layer (ONL)
ganglion cell/inner plexiform layer (GCIPL), and macular volume (MV) were compared
between groups. Mixed-effects regression models adjusting for within-patient inter-eye
correlations, controlling for age, gender, disease duration and history of optic neuritis
per eye were explored. Subgroup analyses were performed on eyes with previous optic
neuritis.
Results
234 eyes (20 pNMOSD, 33 dNMOSD, 138 MS, and 43 HC) were included. Controlling for
age, gender, disease duration, and history of optic neuritis per eye, pNMOSD eyes
showed decreased GCIPL, pRNFL, mRNFL and MV thicknesses, similar to eyes with dNMOSD,
but significantly thinner than MS and HC subjects’ eyes. Similar results were obtained
for the pRNFL, mRNFL, GCIPL, INL and MV thickness in the subgroup analysis exploring
only eyes with history of optic neuritis (12 pNMOSD, 15 dNMOSD, and 27 MS).
Conclusion
Retinal OCT measurements in patients with pNMOSD were similar to dNMOSD, but significantly
lower than patients with MS and healthy controls. This suggests that retinal OCT measures
could be helpful markers supportive of NMOSD diagnosis and should be explored in larger
studies as a valuable addition to the current consensus diagnostic criteria.
Keywords
Abbreviations:
pNMOSD (potential neuromyelitis optica-spectrum disorder), dNMOSD (definite NMO-spectrum disorder), RRMS (relapsing remitting multiple sclerosis), pRNFL (peripapillary retinal nerve fiber layer), INL (inner nuclear layer), mRNFL (macular retinal nerve fiber layer), ONL (outer nuclear layer), GCIPL (ganglion cell/inner plexiform layer), MV (macular volume)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 06, 2022
Accepted:
September 4,
2022
Received in revised form:
August 9,
2022
Received:
June 28,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
