TY - JOUR
T1 - Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study
AU - on behalf of the International Multiple Sclerosis Visual System Consortium
AU - Nolan-Kenney, Rachel C.
AU - Liu, Mengling
AU - Akhand, Omar
AU - Calabresi, Peter A.
AU - Paul, Friedemann
AU - Petzold, Axel
AU - Balk, Lisanne
AU - Brandt, Alexander U.
AU - Martínez-Lapiscina, Elena H.
AU - Saidha, Shiv
AU - Villoslada, Pablo
AU - Al-Hassan, Abdullah Abu
AU - Behbehani, Raed
AU - Frohman, Elliot M.
AU - Frohman, Teresa
AU - Havla, Joachim
AU - Hemmer, Bernhard
AU - Jiang, Hong
AU - Knier, Benjamin
AU - Korn, Thomas
AU - Leocani, Letizia
AU - Papadopoulou, Athina
AU - Pisa, Marco
AU - Zimmermann, Hanna
AU - Galetta, Steven L.
AU - Balcer, Laura J.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Objective: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High- and low-contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. Results: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). Interpretation: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting. Ann Neurol 2019;85:618–629.
AB - Objective: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High- and low-contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. Results: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). Interpretation: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting. Ann Neurol 2019;85:618–629.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064157663&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30851125
U2 - https://doi.org/10.1002/ana.25462
DO - https://doi.org/10.1002/ana.25462
M3 - Article
C2 - 30851125
SN - 0364-5134
VL - 85
SP - 618
EP - 629
JO - Annals of neurology
JF - Annals of neurology
IS - 5
ER -