Retinal nerve fiber layer in multiple sclerosis

To evaluate the usefulness of the retinal nerve fiber layer (RNFL) appearance in estimation of optic nerve damage in MS, we examined 20 patients with definite MS and 20 normal control patients. Photographs of the RNFL in 80 eyes were classified as normal or abnormal by two examiners working independently. The results were very similar, even though the clinical data of which they were informed and their experience with RNFL-evaluation differed. We found RNFL defects in 80% of MS patients and in 73% of MS eyes. In the control group the values were 5% and 2.5%. Subclinical optic neuropathy in eyes without any history of optic neuritis was demonstrated by RNFL defects in 68%. We conclude, that in detecting clinical and subclinical optic neuropathy, RNFL-evaluation is to be recommended as the method of choice.