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No Evidence of Subclinical Retinal Axonal Loss

Olivier Outteryck, MD; Hélène Zephir, MD, PhD; Sabine Defoort, MD; Marie Bouyon, MD; Philippe Debruyne, SysE; Ikram Bouacha, MD; Didier Ferriby, MD; Arnaud Lacour, MD; Pierre Labalette, MD; Jerome de Seze, MD, PhD; Patrick Vermersch, MD, PhD

Arch Neurol. 2009;66(11):1373-1377.

Background  Optical coherence tomography has emerged as a new tool for quantifying axonal loss in multiple sclerosis (MS). A reduction in retinal nerve fiber layer (RNFL) thickness is correlated with Expanded Disability Status Scale score and brain atrophy.

Objective  To investigate RNFL and macular volume measurements using optical coherence tomography in the clinically isolated syndrome population.

Design  Prospective case series.

Settings  Neurologic clinics at the university hospitals of Lille and Strasbourg (France).

Participants  Fifty-six consecutive patients with clinically isolated syndrome (18 with optic neuritis and 38 without optic neuritis) and 32 control subjects.

Main Outcome Measures  Macular volume and RNFL thickness.

Results  Mean (SD) overall RNFL thickness (98.98 [10.26] µm) and macular volume (6.86 [0.32] µm³) in the clinically isolated syndrome population were not significantly different compared with the controls (98.71 [9.08] µm and 6.92 [0.38] µm³, respectively). No link was noted between atrophy of the RNFL or macula and conversion to MS at 6 months.

Conclusions  Optical coherence tomography does not reveal retinal axonal loss at the earliest clinical stage of MS and does not predict conversion to MS at 6 months.

Author Affiliations: Department of Neurology, Université Lille Nord de France, Lille (Drs Outteryck, Zephir, Lacour, and Vermersch); Departments of Neurology (Drs Outteryck, Zephir, Lacour, and Vermersch) and Neuro-Ophthalmology, Salengro Hospital, Université Lille Nord de France, Lille (Drs Defoort, Debruyne, and Bouacha); Department of Neurology, University Hospital of Strasbourg, Strasbourg (Drs Bouyon and de Seze); Department of Neurology, Gustave Dron Hospital, Tourcoing (Dr Ferriby); and Department of Ophthalmology, Huriez Hospital, Université Lille Nord de France II, Lille (Dr Labalette), France.

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