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CNS Involvement in Chronic Inflammatory Demyelinating Polyneuropathy: Subtle Retinal Changes in Optical Coherence
Jens Ingwersen1, Jonas Graf1, Julia Kluge1
1From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
This study found subtle retinal neurodegeneration in patients with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), indicating visual pathway involvement. Optical coherence tomography detected these changes, suggesting potential for early diagnosis.
Area of Science:
- Neuroscience
- Ophthalmology
- Immunology
Background:
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an autoimmune disorder affecting the peripheral nervous system.
- Emerging evidence suggests potential central nervous system (CNS) demyelination in CIDP patients, similar to multiple sclerosis.
- The involvement of the visual pathway in CIDP remains to be fully elucidated.
Purpose of the Study:
- To investigate the involvement of the visual pathway in patients diagnosed with CIDP.
- To compare retinal layer thickness and macular volume in CIDP patients versus healthy controls.
- To explore correlations between retinal changes and clinical/nerve conduction study findings in CIDP.
Main Methods:
- Prospective, cross-sectional study design.
- High-resolution spectral-domain optical coherence tomography (OCT) used for retinal imaging.
- Comparison of peripapillary retinal nerve fiber layer, macular retinal layers, and total macular volume (TMV) between 22 CIDP patients and 22 healthy controls (HC).
- Semiautomated segmentation of retinal layers and correlation with clinical measures and nerve conduction studies.
Main Results:
- Significant reductions in the ganglion cell/inner plexiform layer complex volume (CIDP 1.86 vs HC 1.95 mm³), retinal pigment epithelium (CIDP 0.38 vs HC 0.40 mm³), and TMV (CIDP 8.48 vs HC 8.75 mm³) were observed in CIDP patients compared to HC.
- A positive association was found between ganglion cell layer volume and motor nerve conduction velocity (B = 0.002, p = 0.02).
Conclusions:
- Subtle retinal neurodegeneration is present in CIDP patients.
- Optical coherence tomography (OCT) can detect visual pathway involvement in CIDP.
- Further validation in larger cohorts is warranted to confirm these findings.
