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Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis

Department of Neurology and Neurosurgery, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain

J Sepulcre

Department of Neurology and Neurosurgery, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain

A Salinas-Alaman

Department of Ophthalmology, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain

A García-Layana

Department of Ophthalmology, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain

M Murie-Fernandez

Department of Neurology and Neurosurgery, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain

B Bejarano

Department of Neurology and Neurosurgery, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain

P Villoslada

Department of Neurology and Neurosurgery, Clínica Universitaria de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, Spain pvilloslada{at}unav.es

Background

Studying axonal loss in the retina is a promising biomarker for multiple sclerosis (MS). Our aim was to compare optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT) techniques to measure the thickness of the retinal nerve fiber layer (RNFL) in patients with MS, and to explore the relationship between changes in the RNFL thickness with physical and cognitive disability. We studied 52 patients with MS and 18 proportionally matched controls by performing neurological examination, neuropsychological evaluation using the Brief Repetitive Battery-Neuropsychology and RNFL thickness measurement using OCT and HRT.

Results

We found that both OCT and HRT could define a reduction in the thickness of the RNFL in patients with MS compared with controls, although both measurements were weakly correlated, suggesting that they might measure different aspects of the tissue changes in MS. The degree of RNFL atrophy was correlated with cognitive disability, mainly with the symbol digit modality test (r = 0.754, P < 0.001). Moreover, temporal quadrant RNFL atrophy measured with OCT was associated with physical disability.

Conclusion

In summary, both OCT and HRT are able to detect thinning of the RNFL, but OCT seems to be the most sensitive technique to identify changes associated with MS evolution.

Key Words: cognitive impairment • Heidelberg retinal tomography • multiple sclerosis • optic coherence tomography • physical disability • retinal nerve fiber layer

This version was published on August 1, 2008

Multiple Sclerosis, Vol. 14, No. 7, 906-912 (2008)
DOI: 10.1177/1352458508090221


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