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Published on: August 11, 2016
Functional-structural correlations in the afferent visual pathway in pediatric demyelination.
E Ann Yeh1, Ruth Ann Marrie2, Y Arun Reginald2
1From the Divisions of Neurology (E.A.Y., A.E.N., J.O.) and Ophthalmology (Y.A.R., J.R.B.) and Department of Pediatrics (E.A.Y., A.E.N., J.O.), Hospital for Sick Children, University of Toronto; the Departments of Internal Medicine and Community Health Sciences (R.A.M.), University of Manitoba, Winnipeg, Canada; the Division of Neurology (B.B.), Children's Hospital of Philadelphia, University of Pennsylvania; and Department of Pediatrics (J.K.M.), the University of Calgary (F.C.), Canada. ann.yeh@sickkids.ca.
Children with demyelinating disorders show reduced retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness. This retinal thinning correlates with decreased visual acuity and visual field sensitivity, suggesting primary neuronal injury.
Area of Science:
- Ophthalmology
- Neuroscience
- Pediatrics
Background:
- Pediatric demyelinating disorders can affect the visual pathway.
- Assessing retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness provides insight into neuronal health.
Purpose of the Study:
- To evaluate the relationship between OCT-measured RNFL and GCL thickness and functional visual measures in pediatric demyelinating disorders.
- To investigate potential primary neuronal injury in the retina.
Main Methods:
- Cross-sectional study of 37 children (8-18 years) with demyelinating disorders and 18 healthy controls.
- Standardized visual battery including spectral-domain OCT, visual fields, low-contrast visual acuity (LCVA), and high-contrast visual acuity (HCVA).
Main Results:
- Mean RNFL thickness was 25.6% lower and GCL thickness was 20% lower in patients compared to controls (p < 0.0001).
- RNFL and GCL thickness were strongly correlated (r = 0.89; p < 0.0001).
- Reduced RNFL thickness correlated linearly with decreased HCVA, LCVA, and visual field sensitivity.
Conclusions:
- Ganglion cell layer (GCL) thickness was reduced in patients irrespective of optic neuritis history.
- The findings suggest the retina may be a site of primary neuronal injury in pediatric demyelination.
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