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Ganglion cell loss in relation to visual disability in multiple sclerosis
Scott D Walter1, Hiroshi Ishikawa, Kristin M Galetta
1Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Ophthalmology
|February 28, 2012
Summary
Ganglion cell loss, a key indicator in multiple sclerosis (MS), significantly impacts vision and quality of life. Spectral-domain optical coherence tomography (SD-OCT) reveals this thinning, offering a potential marker for disease progression.
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Optic neuritis (ON) is a common early symptom of MS, often leading to vision impairment.
- Assessing structural changes in the retina can provide insights into MS-related visual dysfunction.
Purpose of the Study:
- To investigate the relationship between ganglion cell loss and history of acute optic neuritis (ON) in MS patients.
- To correlate retinal nerve fiber layer (RNFL) thinning with visual function and quality of life (QOL) in MS.
- To utilize high-resolution spectral-domain optical coherence tomography (SD-OCT) with retinal segmentation for precise measurements.
Main Methods:
- A cross-sectional study involving 122 MS patients (239 eyes) and 31 healthy controls (61 eyes).
- SD-OCT imaging (Macular Cube and ONH Cube protocols) was used to measure retinal layer thicknesses.
- Segmentation algorithms, adapted from glaucoma studies, were applied to quantify GCL+IPL, RNFL, and other retinal layers.
Main Results:
- Significant reductions in macular RNFL and GCL+IPL were observed in MS eyes compared to controls, and in MS eyes with a history of ON.
- RNFL and GCL+IPL thicknesses strongly correlated with visual acuity (VA) and low-contrast letter acuity (LCLA).
- GCL+IPL thinning showed the strongest association with reduced vision-specific QOL (NEI-VFQ-25), even after accounting for RNFL thickness.
Conclusions:
- Ganglion cell layer/inner plexiform layer (GCL+IPL) thinning is a significant correlate of visual function and QOL in MS.
- GCL+IPL thinning may serve as a valuable structural biomarker for neurological disability in MS.
- Findings align with MRI studies highlighting gray matter disease as a marker of disability in MS.
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