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Diagnostic accuracy of inter-eye difference of ganglion cell layer alone in identifying optic neuritis in multiple
Nik Krajnc1,2, Fabian Föttinger1,2, Markus Ponleitner1,2
1Department of Neurology, Medical University of Vienna, Vienna, Austria.
Introduction:
The 2024 McDonald criteria for diagnosing multiple sclerosis (MS) include optic nerve involvement as a fifth region for establishing dissemination in space. Optic neuritis (ON) can be detected through optical coherence tomography (OCT) using an inter-eye absolute or percentage difference (IEAD, IEPD) in ganglion cell-inner plexiform layer (GCIPL) thickness.
Objective:
To compare the diagnostic accuracy of GCIPL IEAD/IEPD with GCL and IPL IEAD/IEPD alone for identifying a history of ON.
Methods:
This cross-sectional retrospective study included people with MS (pwMS) who underwent an OCT scan. Diagnostic accuracy was assessed using ROC analysis.
Results:
A total of 241 pwMS (mean age 34.7 years [SD 9.7], 70.1% female) were included. Sixty-eight (28.2%) patients had a documented history of unilateral ON. GCL IEAD (AUC 0.79, cut-off ⩾ 0.06 mm3 or ⩾2µm, 58.9% sensitivity, 85.1% specificity) and IEPD (AUC 0.80, cut-off ⩾ 3%, 48.7% sensitivity, 89.8% specificity) demonstrated excellent diagnostic accuracy for unilateral ON, showing non-inferiority to the established GCIPL IEAD/IEPD.
Conclusion:
GCL IEAD and IEPD provide strong diagnostic accuracy for identifying unilateral ON and can be effectively used as an alternative to GCIPL IEAD/IEPD to facilitate implementation in clinical routine.
