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Retinal Optical Coherence Tomography in Neuromyelitis Optica Publisher



Oertel FC1, 2 ; Specovius S1 ; Zimmermann HG1 ; Chien C1, 3 ; Motamedi S1 ; Bereuter C1 ; Cook L1 ; Lana Peixoto MA4 ; Fontanelle MA4 ; Kim HJ5 ; Hyun JW5 ; Palace J6, 7 ; Rocafernandez A6 ; Leite MI1 Show All Authors
Authors
  1. Oertel FC1, 2
  2. Specovius S1
  3. Zimmermann HG1
  4. Chien C1, 3
  5. Motamedi S1
  6. Bereuter C1
  7. Cook L1
  8. Lana Peixoto MA4
  9. Fontanelle MA4
  10. Kim HJ5
  11. Hyun JW5
  12. Palace J6, 7
  13. Rocafernandez A6
  14. Leite MI1
  15. Sharma S1
  16. Ashtari F8
  17. Kafieh R1
  18. Dehghani A1
  19. Pourazizi M1
  20. Pandit L9
  21. Dcunha A9
  22. Aktas O10
  23. Ringelstein M1
  24. Albrecht P10
  25. May E11
  26. Tongco C11
  27. Leocani L1
  28. Pisa M1
  29. Radaelli M12
  30. Martinezlapiscina EH1
  31. Stiebelkalish H13, 14
  32. Siritho S15
  33. De Seze J16
  34. Senger T1
  35. Havla J17
  36. Marignier R18
  37. Calvo AC18, 19
  38. Bichuetti D20
  39. Tavares IM20
  40. Asgari N21, 22
  41. Soelberg K22
  42. Altintas A23
  43. Yildirim R1
  44. Tanriverdi U23
  45. Jacob A24, 25
  46. Huda S24
  47. Rimler Z26
  48. Reid A26
  49. Maodraayer Y27
  50. Soto De Castillo I28
  51. Petzold A29
  52. Green AJ1
  53. Yeaman MR30, 31, 32
  54. Smith T33, 34
  55. Brandt AU35
  56. Paul F36

Source: Neurology: Neuroimmunology and NeuroInflammation Published:2021


Abstract

Background and ObjectivesTo determine optic nerve and retinal damage in aquaporin-4 antibody (AQP4-IgG)-seropositive neuromyelitis optica spectrum disorders (NMOSD) in a large international cohort after previous studies have been limited by small and heterogeneous cohorts.MethodsThe cross-sectional Collaborative Retrospective Study on retinal optical coherence tomography (OCT) in neuromyelitis optica collected retrospective data from 22 centers. Of 653 screened participants, we included 283 AQP4-IgG-seropositive patients with NMOSD and 72 healthy controls (HCs). Participants underwent OCT with central reading including quality control and intraretinal segmentation. The primary outcome was thickness of combined ganglion cell and inner plexiform (GCIP) layer; secondary outcomes were thickness of peripapillary retinal nerve fiber layer (pRNFL) and visual acuity (VA).ResultsEyes with ON (NMOSD-ON, N = 260) or without ON (NMOSD-NON, N = 241) were assessed compared with HCs (N = 136). In NMOSD-ON, GCIP layer (57.4 ± 12.2 m) was reduced compared with HC (GCIP layer: 81.4 ± 5.7 m, p < 0.001). GCIP layer loss (-22.7 m) after the first ON was higher than after the next (-3.5 m) and subsequent episodes. pRNFL observations were similar. NMOSD-NON exhibited reduced GCIP layer but not pRNFL compared with HC. VA was greatly reduced in NMOSD-ON compared with HC eyes, but did not differ between NMOSD-NON and HC.DiscussionOur results emphasize that attack prevention is key to avoid severe neuroaxonal damage and vision loss caused by ON in NMOSD. Therapies ameliorating attack-related damage, especially during a first attack, are an unmet clinical need. Mild signs of neuroaxonal changes without apparent vision loss in ON-unaffected eyes might be solely due to contralateral ON attacks and do not suggest clinically relevant progression but need further investigation. © American Academy of Neurology.
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