Logo for the Journal of Rehab R and D

Volume 46 Number 5, 2009
   Pages 633 — 642

Abstract – Thickness of retinal nerve fiber layer correlates with disease duration
in parallel with corticospinal tract dysfunction in untreated multiple sclerosis

Rebecca I. Spain, MD;1-3* Mitchell Maltenfort, PhD;4 Robert C. Sergott, MD;5 Thomas P. Leist, MD, PhD6

1Department of Neurology, Thomas Jefferson University, Philadelphia, PA; 2Department of Neurology, Oregon Health & Science University School of Medicine, Portland, OR; 3Neurology Service, Portland Department of Veterans Affairs Medical Center, Portland, OR; 4Department of Neurological Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA; 5Neuro-Ophthalmology Service, Wills Eye Institute, Thomas Jefferson University,
Philadelphia, PA; 6Comprehensive Multiple Sclerosis Center, Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA

Abstract — Optical coherence tomography (OCT) is an emerging clinical and research measure of retinal nerve fiber layer (RNFL) loss in multiple sclerosis (MS) and may reflect neurodegeneration. Few studies capture the effect of disease duration on the RNFL in subjects without exposure to disease-modulating therapies. We assessed the relationship of RNFL loss with disease duration in subjects with untreated MS and determined if such loss paralleled corticospinal tract dysfunction in MS. Subjects underwent OCT (n = 52) and visual testing (n = 60). Either they were either examined or they participated in a validated telephone interview so we could determine their Expanded Disability Status Scale (EDSS) scores. Both RNFL thickness (Spearman rs = -0.47, p < 0.001) and EDSS scores (rs = 0.51, p < 0.001) correlated with disease duration. RNFL thickness correlated with EDSS scores (rs = -0.43, p < 0.001). In conclusion, RNFL loss correlates with disease duration and EDSS scores in subjects with untreated MS, indicating that OCT may capture neurodegeneration.

Key words: disease duration, disease-modifying therapy, Expanded Disability Status Scale, multiple sclerosis, neurodegeneration, optic nerve diseases, optical coherence tomography, rehabilitation, retinal nerve fiber layer, visual acuity.

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