The thickness of retinal nerve fiber layer and structural changes of inner macular segmented layers in optic neuritis patients with positive aquaporin-4 antibody_Chinese Journal of Ocular Fundus Diseases

Authors：

PengChunxia , CaoShanshan , ZhaoShuo , 康皓 , 周欢粉 , 杨沫 , 徐全刚 ,  魏世辉

Department of Ophthalmology, PLA General Hospital, Beijing 100853, China;

Corresponding author：

魏世辉, Email: weishihui706@hotmail.com

Keywords：

Optic neuritis/physiopathology; Optic neuritis/diagnosis; Macula lutea/physiopathology; Aquaporin 4; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2015.06.006

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Objective To observe the thickness of per-papillary retinal fiber layer (pRNFL) and structural changes of inner macular segmented layers in optic neuritis (ON) patients with positive aquaporin-4 antibody[AQP4-Ab(+)]. Methods 60 ON patients (84 eyes) including 30 of AQP4-Ab(+) ON patients (42 eyes) and AQP4-Ab(-) ON patients (42 eyes), and 40 age-gender matched health controls(80 eyes) were recruited in present study. There was no statistical significance in gender (χ²=0.568) and age (χ²=1.472) between the three groups (P > 0.05). There was no statistical significance in the percentage of different course (χ²=0.000) and logMAR best corrected visual acuity (Z=-1.492) between AQP4-Ab(+)ON and AQP4-Ab(-)ON group (P=1.000, 0.136). All subjects were examined by Spectralis-OCT. The thickness of per-papillary, nasal, nasal lower, temporal lower, temporal, temporal upper, nasal upper and papillomacular bundle (PMB) were analyzed as well as nasal pRNFL/temporal pRNFL (N/T). The macular area was divided into three concentric circles which including central region with 1 mm diameter, inner area with > 1 mm but≤3 mm diameter, and outer ring area with > 3 mm but≤6 mm diameter. The macular volume in each partition and volume in macular RNFL (mRNFL), macular ganglion cell layer (mRGCL), macular inner plexiform layer (mIPL) and macular inner nuclear layer (mINL) were analyzed. Results Compared to HC group, the thickness of pRNFL, every quadrants and PMB were decreased significantly in ON group (P=0.000); the macular volume and the volume of mRNFL, mRGCL, mIPL were also decreased significantly in ON group (P=0.000); but there was no statistical difference in mINL volume between two groups (P=0.700). Compared to AQP4-Ab(-)ON group, the thickness of nasal and nasal lower were decreased significantly in AQP4-Ab(+)ON group (P=0.010, 0.000); the macular and mIPL volume were also decreased significantly in AQP4-Ab(+)ON group (P=0.038, 0.033); the thickness of inferior, superior and inferior mIPL in outer ring area and nasal mRNFL in inner area were decreased significantly in AQP4-Ab(+)ON group (P < 0.05). Conclusions Compared to AQP4-Ab(-)ON patients, the pRNFL thickness and mIPL volume decreased in AQP4-Ab(+)ON patients. The thinner pRNFL area is mainly located in nasal, nasal lower quadrants, and inferior, superior mIPL.

Citation： PengChunxia, CaoShanshan, ZhaoShuo. The thickness of retinal nerve fiber layer and structural changes of inner macular segmented layers in optic neuritis patients with positive aquaporin-4 antibody. Chinese Journal of Ocular Fundus Diseases, 2015, 31(6): 536-540. doi: 10.3760/cma.j.issn.1005-1015.2015.06.006 Copy

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1. Levin MH, Bennett JL, Verkman AS.Optic neuritis in neuromyelitis optica[J]. Prog Retin Eye Res, 2013, 36:159-171.
2. Arellano G, Ottum PA, Reyes LI, et al.Stage-specific role of interferon-gamma in experimental autoimmune encephalomyelitis and multiple sclerosis[J].Front Immunol, 2015, 29(6):492.
3. Wingerchuk DM, Lennon VA, Lucchinetti CF, et al.The spectrum of neuromyelitis optica[J]. Lancet Neurol, 2007, 6(9):805-815.
4. Group ONS. The clinical profile of optic neuritis. Experience of the Optic Neuritis Treatment Trial. Optic Neuritis Study Group[J].Arch Ophthalmol, 1991, 109(12):1673-1678.
5. Schulze-Bonsel K, Feltgen N, Burau H, et al.Visual acuities "hand motion" and "counting fingers" can be quantified with the freiburg visual acuity test[J].Invest Ophthalmol Vis Sci, 2006, 47(3): 1236-1240.
6. Shrier EM, Adam CR, Spund B, et al. Interocular asymmetry of foveal thickness in Parkinson disease[J/OL]. J Ophthalmol, 2012, 2012:728457[2012-08-01].http://dx.doi.org/10.1155/2012/728457..
7. Ratchford JN, Quigg ME, Conger A, et al.Optic coherence tomography helps differentiate neuromyelitis optica and MS optic neuropathies[J]. Neurology, 2009, 73(4): 302-308.
8. Naismith RT, Tutlam NT, Xu J, et al.Optical coherence tomography differs in neuromyelitis optica compared with multiple sclerosis[J]. Neurology, 2009, 72(12):1077-1082.
9. Monteiro ML, Fernandes DB, Apóstolos-Pereira SL, et al. Quantification of retinal neural loss in patient s with neuromyelitis optica and multiple sclerosis with or without optic neuritis using Fourier-domain optical coherence tomography[J].Invest Ophthalmol Vis Sci, 2012, 53(7):3959-3966.
10. Schneider E, Zimmermann H, Oberwahrenbrock T, et al. Optical coherence tomography reveals distinct patterns of retinal damage in neuromyelitis optica and multiple sclerosis[J/OL].PLoS One, 2013, 8:66151[2013-06-21]. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689687/.
11. Fernandes DB, Raza AS, Nogueira RG, et al. Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography[J]. Ophthalmology, 2013, 120(2):387-394.
12. Lucchinetti CF, Guo Y, Popescu BF, et al.The pathology of an autoimmune astrocytopathy: lessons learned from neuromyelitis optica[J]. Brain Pathol, 2014, 24(1):83-97.
13. Kerrison JB, Flynn T, Green WR. Retinal pathologic changes in multiplesclerosis[J]. Retina, 1994, 14(5):445-451.
14. Green AJ, McQuaid S, Hauser SL, et al. Ocular pathology in multiple sclerosis: retinal atrophy and inflammation irrespective of disease duration[J].Brain, 2010, 133(Pt 6):1591-1601.
15. Syc SB, Saidha S, Newsome SD, et al. Optical coherence tomography segmentation reveals ganglion layer pathology after optic neuritis[J].Brain, 2012, 135(Pt 2):521-533.
16. Sellner J, Boggild M, Clanet M, et al.EFNS guidelines on diagnosis andmanagement of neuromyelitis optica[J].Eur J Neurol, 2010, 17(8):1019-1032.

Chinese Journal of Ocular Fundus Diseases

The thickness of retinal nerve fiber layer and structural changes of inner macular segmented layers in optic neuritis patients with positive aquaporin-4 antibody

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