Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis

Rebecca I. Spain; Liang Liu; Xinbo Zhang; Yali Jia; Ou Tan; Dennis Bourdette; David Huang

doi:10.1136/bjophthalmol-2017-310477

Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis

Rebecca I. Spain
, Liang Liu
, Xinbo Zhang
, Yali Jia
, Ou Tan
, Dennis Bourdette
, David Huang

Research output: Contribution to journal › Article › peer-review

128 Scopus citations

Abstract

Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MSâ 'ON). MSâ 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.

Original language	English (US)
Pages (from-to)	520-524
Number of pages	5
Journal	British Journal of Ophthalmology
Volume	102
Issue number	4
DOIs	https://doi.org/10.1136/bjophthalmol-2017-310477
State	Published - Apr 2018

Funding

Contributors RIS, LL, DB and DH: conception, design, analysis and interpretation of data. RIS, LL, DH: drafting the article. XZ, YJ and OT; revising it critically for important intellectual content. DB, RIS and DH: final approval of the version to be published. All authors read and approved the final manuscript Funding This study was supported by the following NIH grants: UL1TR000128, UL1 RR024140, R01-EY013516, R01-EY023285, DP3 DK104397 and P30 EY010572 (Bethesda, MD). Additional support includes a grant from the Medical Research Foundation of Oregon (GNEUR0728A) and a Career Development Award from the Department of Veterans Affairs (B7493-W, Rebecca Spain). Supported by unrestricted departmental funding from Research to Prevent Blindness (New York, USA). Oregon Health & Science University (OHSU) foundation, NSFC (Grant No. 61471226) and the Champalimaud Foundation (Lisbon, Portugal).

Funders	Funder number
Champalimaud Clinical Center/Champalimaud Foundation and ABC Global Alliance
Department of Veterans Affairs	B7493-W
Oregon Medical Research Foundation	GNEUR0728A
NIH NIH/NCCAM	UL1TR000128, R01-EY023285, DP3 DK104397, P30 EY010572, R01-EY013516, UL1 RR024140
Research to Prevent Blindness
University (OHSU) foundation
National Institute of Diabetes and Digestive and Kidney Diseases	DP3DK104397
Oregon State University/Oregon Health and Science University
The National Natural Science Foundation of China	61471226

Keywords

OCT angiography
multiple sclerosis
optic neuritis
optical coherence tomography
retina

ASJC Scopus subject areas

Ophthalmology
Sensory Systems
Cellular and Molecular Neuroscience

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10.1136/bjophthalmol-2017-310477

Cite this

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title = "Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis",

abstract = "Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MS{\^a} 'ON). MS{\^a} 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.",

keywords = "OCT angiography, multiple sclerosis, optic neuritis, optical coherence tomography, retina",

author = "Spain, \{Rebecca I.\} and Liang Liu and Xinbo Zhang and Yali Jia and Ou Tan and Dennis Bourdette and David Huang",

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T1 - Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis

AU - Spain, Rebecca I.

AU - Liu, Liang

AU - Zhang, Xinbo

AU - Jia, Yali

AU - Tan, Ou

AU - Bourdette, Dennis

AU - Huang, David

PY - 2018/4

Y1 - 2018/4

N2 - Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MSâ 'ON). MSâ 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.

AB - Background Quantitative assessment of optic nerve damage is important in the evaluation of optic neuritis (ON) and multiple sclerosis (MS). Objective To detect optic nerve damage using optical coherence tomography (OCT) and OCT angiography in MS. Methods Peripapillary retinal nerve fibre layer (NFL) thickness, macular ganglion cell complex (GCC) thickness and Optic Nerve Head Flow Index (ONH-FI) were measured. The ONH-FI was defined as flow signal averaged over the optic disc. Diagnostic accuracy was evaluated by the area under the receiver-operating characteristics curve (AROC). Results Sixty-eight eyes of 45 MS participants and 55 eyes of 32 healthy controls (HCs) were analysed. Of MS eyes, 25 had a history of ON (MS+ON) and 43 didn't (MSâ 'ON). MSâ 'ON and MS+ON eyes had reductions in ONH-FI (p=0.031 and p=0.001, respectively), GCC thickness (p=0.245 and p<0.001, respectively), and NFL thickness (p=0.003 and p=0.024, respectively), compared with HCs. The highest AROC (0.940) was achieved by the logistic regression combination of all three variables, which was significantly higher than other variables (p=0.018). Conclusion MS produces both retinal structural loss and decreased ONH perfusion in MS eyes with and without history of ON. The combination of perfusion and structural measurements enhances detection of optic nerve damage in MS. OCT angiography may be a useful additional retinal marker in evaluation of ON in MS.

KW - OCT angiography

KW - multiple sclerosis

KW - optic neuritis

KW - optical coherence tomography

KW - retina

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Optical coherence tomography angiography enhances the detection of optic nerve damage in multiple sclerosis

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