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Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis

Authors

  • S. Anand Trip MRCP,

    Corresponding author
    1. NMR Research Unit, Department of Neuroinflammation, Brain Injury and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
    2. Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
    • NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom
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  • Patricio G. Schlottmann MD,

    1. Glaucoma Research Unit, Moorfields Eye Hospital, London, United Kingdom
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  • Stephen J. Jones PhD,

    1. Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
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  • Daniel R. Altmann DPhil,

    1. NMR Research Unit, Department of Neuroinflammation, Brain Injury and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
    2. Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom
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  • David F. Garway-Heath FRCOphth,

    1. Glaucoma Research Unit, Moorfields Eye Hospital, London, United Kingdom
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  • Alan J. Thompson FRCP,

    1. NMR Research Unit, Department of Neuroinflammation, Brain Injury and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
    2. Department of Headache, Brain Injury and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
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  • Gordon T. Plant FRCP,

    1. Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
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  • David H. Miller FRCP

    1. NMR Research Unit, Department of Neuroinflammation, Brain Injury and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom
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Abstract

Axonal loss is thought to be a likely cause of persistent disability after a multiple sclerosis relapse; therefore, noninvasive in vivo markers specific for axonal loss are needed. We used optic neuritis as a model of multiple sclerosis relapse to quantify axonal loss of the retinal nerve fiber layer (RNFL) and secondary retinal ganglion cell loss in the macula with optical coherence tomography. We studied 25 patients who had a previous single episode of optic neuritis with a recruitment bias to those with incomplete recovery and 15 control subjects. Optical coherence tomography measurement of RNFL thickness and macular volume, quantitative visual testing, and electrophysiological examination were performed. There were highly significant reductions (p < 0.001) of RNFL thickness and macular volume in affected patient eyes compared with control eyes and clinically unaffected fellow eyes. There were significant relationships among RNFL thickness and visual acuity, visual field, color vision, and visual-evoked potential amplitude. This study has demonstrated functionally relevant changes indicative of axonal loss and retinal ganglion cell loss in the RNFL and macula, respectively, after optic neuritis. This noninvasive RNFL imaging technique could be used in trials of experimental treatments that aim to protect optic nerves from axonal loss. Ann Neurol 2005

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