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Retrograde trans-synaptic visual pathway degeneration in multiple sclerosis: A case series.
Omar Al-Louzi1, Julia Button1, Scott D Newsome1
1The Division of Neuroimmunology and Neurological Infections, Department of Neurology, The Johns Hopkins hospital, Baltimore, MD, USA.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|April 8, 2017
Summary
Trans-synaptic degeneration (TSD) may cause retinal atrophy in multiple sclerosis (MS). This study observed ganglion cell + inner plexiform layer thinning in MS patients with visual pathway lesions, suggesting TSD is a key factor.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Trans-synaptic degeneration (TSD) is neuronal injury propagation via synaptic pathways.
- TSD may explain accelerated retinal atrophy in multiple sclerosis (MS).
Purpose of the Study:
- To investigate the link between posterior visual pathway lesions and retinal changes in MS.
- To assess the utility of ganglion cell + inner plexiform (GCIP) layer thickness in identifying TSD.
Main Methods:
- Case series analysis of six MS patients.
- Optical coherence tomography (OCT) to measure retinal layer thickness.
- Correlation of GCIP thickness with posterior visual pathway lesions.
Main Results:
- Six cases showed homonymous hemi-macular GCIP thickness reduction.
- Posterior visual pathway lesions were present in these cases.
- Three subjects exhibited inner nuclear layer microcystoid changes.
Conclusions:
- Regional GCIP changes are useful indicators of retrograde TSD in MS.
- Inner nuclear layer changes may accompany TSD in MS patients.