Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis

• Published in: Multiple sclerosis Vol. 14; no. 7; pp. 906 - 912
• Main Authors: Toledo, J, Sepulcre, J, Salinas-Alaman, A, García-Layana, A, Murie-Fernandez, M, Bejarano, B, Villoslada, P
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-08-2008; Arnold; Sage Publications Ltd
• Subjects: Adult; Atrophy; Biological and medical sciences; Cognition Disorders - pathology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disease Progression; Female; Humans; Male; Medical sciences; Memory; Middle Aged; Multiple Sclerosis - pathology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nerve Fibers - pathology; Neurology; Neuropsychological Tests; Optic Nerve - pathology; Optic Neuritis - pathology; Tomography, Optical Coherence; optic coherence tomography; cognitive impairment; Heidelberg retinal tomography; retinal nerve fiber layer; multiple sclerosis; physical disability; Nervous system diseases; Multiple sclerosis; Cognitive disorder; Retina; Developmental disorder; Mental retardation; Inflammatory disease; Eye; Atrophy; Disability; Visual system; Central nervous system disease; Coherence; Intellectual deficiency; Tomography; Degenerative disease; Nerve fiber
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458508090221

Background
Studying axonal loss in the retina is a promising biomarker for multiple sclerosis (MS). Our aim was to compare optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT) techniques to measure the thickness of the retinal nerve fiber layer (RNFL) in patients with MS, and to explore the relationship between changes in the RNFL thickness with physical and cognitive disability. We studied 52 patients with MS and 18 proportionally matched controls by performing neurological examination, neuropsychological evaluation using the Brief Repetitive Battery-Neuropsychology and RNFL thickness measurement using OCT and HRT.
Results
We found that both OCT and HRT could define a reduction in the thickness of the RNFL in patients with MS compared with controls, although both measurements were weakly correlated, suggesting that they might measure different aspects of the tissue changes in MS. The degree of RNFL atrophy was correlated with cognitive disability, mainly with the symbol digit modality test (r = 0.754, P < 0.001). Moreover, temporal quadrant RNFL atrophy measured with OCT was associated with physical disability.
Conclusion
In summary, both OCT and HRT are able to detect thinning of the RNFL, but OCT seems to be the most sensitive technique to identify changes associated with MS evolution.