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Marius Ringelstein - One of the best experts on this subject based on the ideXlab platform.
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Retinal Pathology in susac syndrome detected by spectral domain optical coherence tomography
Neurology, 2015Co-Authors: Marius Ringelstein, Philipp Albrecht, Jens Harmel, Ann-kristin Müller, David Finis, Rainer Guthoff, Ilka Kleffner, Bjorn Buhn, Richard Bergholz, Thomas DuningAbstract:Objective: The aim of this non-interventional study was to characterize Retinal layer Pathology in Susac syndrome (SuS), a disease with presumably autoimmune-mediated microvessel occlusions in the retina, brain, and inner ear, in comparison to the most important differential diagnosis multiple sclerosis (MS). Methods: Seventeen patients with SuS and 17 age- and sex-matched patients with relapsing-remitting MS (RRMS) and healthy controls (HC) were prospectively investigated by spectral-domain optical coherence tomography (OCT) including intraRetinal layer segmentation in a multicenter study. Patients with SuS additionally received Retinal fluorescein angiography (FA) and automated perimetry. Results: Patchy thinning of the Retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer plexiform layer compared to corresponding sectors in RRMS and HC eyes ( p Conclusion: Distinct OCT patterns of scattered, scar-like intraRetinal Pathology in SuS eyes, sparing the ONL and PRL, suggest a Retinal, but not choroidal, vascular pathomechanism and clearly differentiate SuS from RRMS. Depending on the disease stage, OCT and FA provide specific complementary diagnostic information in SuS.
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Retinal Pathology in idiopathic moyamoya angiopathy detected by optical coherence tomography
Neurology, 2015Co-Authors: Philipp Albrecht, Marius Ringelstein, Jens Harmel, Ann-kristin Müller, David Finis, Rainer Guthoff, Christine Blasberg, Sebastian Lukas, Ella-maria Kadas, Orhan AktasAbstract:Objective: To investigate whether patients with moyamoya angiopathy without obvious Retinal pathologies such as Retinal infarctions or the congenital morning glory anomaly may have subtle subclinical Retinal changes. Methods: In this cross-sectional study, spectral domain optical coherence tomography was used to analyze the Retinal morphology of 25 patients with idiopathic moyamoya angiopathy and 25 age- and sex-matched healthy controls. We analyzed the Retinal vasculature with blue laser autofluorescence, lipofuscin deposits with MultiColor confocal scanning laser ophthalmoscopy, and the optic nerve head (ONH) volume with a custom postprocessing algorithm. In addition to the total Retinal thickness, semiautomated segmentation was used for segmentation of Retinal layers in macular cross scans, macular volume scans, and peripapillary ring scans. Results: The main finding was a pronounced reduction of the ONH volume in moyamoya angiopathy compared with controls (0.76 ± 0.45 mm 3 and 1.47 ± 0.50 mm 3 , respectively; p 3 and 1.10 ± 0.10 mm 3 , respectively; p Conclusion: Our results indicate that even patients with moyamoya angiopathy who do not have obvious Retinal abnormalities have Retinal abnormalities. These can be detected by spectral domain optical coherence tomography, and the association of ONH abnormalities with the vascular changes may suggest that idiopathic moyamoya angiography is a systemic disease involving abnormalities of the early mesodermal development.
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Subtle Retinal Pathology in amyotrophic lateral sclerosis
Annals of clinical and translational neurology, 2014Co-Authors: Marius Ringelstein, Philipp Albrecht, Martin Südmeyer, Jens Harmel, Ann-kristin Müller, Nazmiye Keser, David Finis, Stefano Ferrea, Rainer Guthoff, Alfons SchnitzlerAbstract:Amyotrophic lateral sclerosis (ALS) is characterized by neuro-ophthalmological abnormalities beyond disturbed oculomotor control such as decreased visual acuity and disturbed visual evoked potentials. Here we report Retinal alterations in a cohort of 24 patients with clinically definite (n = 20) or probable (n = 4) ALS as compared to matched controls. High-resolution spectral domain optical coherence tomography with Retinal segmentation revealed a subtle reduction in the macular thickness and the Retinal nerve fiber layer (RNFL) as well as a marked thinning of the inner nuclear layer (INL). Our data indicate an unprecedented Retinal damage pattern and suggest neurodegeneration beyond the motor system in this disease.
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Patterns of Retinal damage facilitate differential diagnosis between Susac syndrome and MS.
PLoS ONE, 2012Co-Authors: Alexander U Brandt, Marius Ringelstein, Orhan Aktas, Sven Schippling, David Finis, Hanna Zimmermann, Falko Kaufhold, Julia Promesberger, Christian Geis, E. Bernd RingelsteinAbstract:Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch Retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of Retinal structures and is increasingly established to depict characteristic patterns of Retinal Pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of Retinal Pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both Retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS.
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primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (<1st percentile). These in vivo findings are in line with a recent post-mortem analysis reporting Retinal Pathology in multiple sclerosis beyond damage to the RNFL and the ganglion cell layer (Green et al ., 2010). These data are intriguing in that they point to a novel concept of primary Retinal damage in multiple sclerosis. They indicate that Retinal Pathology might not only develop as a consequence of inflammatory attacks to the anterior optic pathway causing …
James G. Fujimoto - One of the best experts on this subject based on the ideXlab platform.
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Projection OCT fundus imaging for visualising outer Retinal Pathology in non-exudative age-related macular degeneration
The British journal of ophthalmology, 2008Co-Authors: Iwona Gorczynska, Joel S. Schuman, Vivek J. Srinivasan, Laurel N. Vuong, Royce W.s. Chen, Jonathan J. Liu, Elias Reichel, Maciej Wojtkowski, Jay S. Duker, James G. FujimotoAbstract:Aims: To demonstrate ultrahigh-resolution, three-dimensional optical coherence tomography (3D-OCT) and projection OCT fundus imaging for enhanced visualisation of outer Retinal Pathology in non-exudative age-related macular degeneration (AMD). Methods: A high-speed, 3.5 μm resolution OCT prototype instrument was developed for the ophthalmic clinic. Eighty-three patients with non-exudative AMD were imaged. Projection OCT fundus images were generated from 3D-OCT data by selectively summing different Retinal depth levels. Results were compared with standard ophthalmic examination, including fundus photography and fluorescein angiography, when indicated. Results: Projection OCT fundus imaging enhanced the visualisation of outer Retinal Pathology in non-exudative AMD. Different types of drusen exhibited distinct features in projection OCT images. Photoreceptor disruption was indicated by loss of the photoreceptor inner/outer segment (IS/OS) boundary and external limiting membrane (ELM). RPE atrophy can be assessed using choroid-level projection OCT images. Conclusions: Projection OCT fundus imaging facilities rapid interpretation of large 3D-OCT data sets. Projection OCT enhances contrast and visualises outer Retinal Pathology not visible with standard fundus imaging or OCT fundus imaging. Projection OCT fundus images enable registration with standard ophthalmic diagnostics and cross-sectional OCT images. Outer Retinal alterations can be assessed and drusen morphology, photoreceptor impairment and pigmentary abnormalities identified.
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ultrahigh resolution optical coherence tomography for enhanced visualization of Retinal Pathology
Biomedical optics, 2003Co-Authors: Wolfgang Drexler, L.a. Paunescu, Joel S. Schuman, Ingmar Hartl, Ravi K Ghanta, James G. FujimotoAbstract:An ultrahigh resolution ophthalmic optical coherence tomography (OCT) system has been developed. Using a femtosecond Ti:sapphire laser light source, which generates bandwidths of ~150 nm at 800 nm, real-time, cross-sectional imaging of the retina with ~3 μm axial resolution is possible. Ultrahigh resolution OCT images of Retinal morphology were obtained in normal subjects and patients with Retinal disease. IntraRetinal architectural morphology associated with macular diseases such as macular edema, epiRetinal membranes, and macular holes can be visualized with unprecedented resolution. Ultrahigh resolution ophthalmic OCT promises to improve the early diagnosis of Retinal diseases as well as enable monitoring of disease progression and the efficacy of therapeutic intervention.
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Ultrahigh resolution OCT imaging of Retinal Pathology in the ophthalmology clinic
2003Co-Authors: A.m. Kowalevicz, L.a. Paunescu, Joel S. Schuman, Wolfgang Drexler, Ingmar Hartl, Franz X. Kaertner, James G. FujimotoAbstract:An ultrahigh resolution ophthalmic optical coherence tomography (OCT) system with 3 /spl mu/m resolution was developed using a femtosecond Ti:Sapphire laser light source. Studies on patients in the ophthalmology clinic demonstrate that ultrahigh resolution dramatically improves visualization of Retinal Pathology.
Alexander U Brandt - One of the best experts on this subject based on the ideXlab platform.
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Patterns of Retinal damage facilitate differential diagnosis between Susac syndrome and MS.
PLoS ONE, 2012Co-Authors: Alexander U Brandt, Marius Ringelstein, Orhan Aktas, Sven Schippling, David Finis, Hanna Zimmermann, Falko Kaufhold, Julia Promesberger, Christian Geis, E. Bernd RingelsteinAbstract:Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch Retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of Retinal structures and is increasingly established to depict characteristic patterns of Retinal Pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of Retinal Pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both Retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS.
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primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (<1st percentile). These in vivo findings are in line with a recent post-mortem analysis reporting Retinal Pathology in multiple sclerosis beyond damage to the RNFL and the ganglion cell layer (Green et al ., 2010). These data are intriguing in that they point to a novel concept of primary Retinal damage in multiple sclerosis. They indicate that Retinal Pathology might not only develop as a consequence of inflammatory attacks to the anterior optic pathway causing …
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Primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (
Sven Schippling - One of the best experts on this subject based on the ideXlab platform.
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Patterns of Retinal damage facilitate differential diagnosis between Susac syndrome and MS.
PLoS ONE, 2012Co-Authors: Alexander U Brandt, Marius Ringelstein, Orhan Aktas, Sven Schippling, David Finis, Hanna Zimmermann, Falko Kaufhold, Julia Promesberger, Christian Geis, E. Bernd RingelsteinAbstract:Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch Retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of Retinal structures and is increasingly established to depict characteristic patterns of Retinal Pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of Retinal Pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both Retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS.
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primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (<1st percentile). These in vivo findings are in line with a recent post-mortem analysis reporting Retinal Pathology in multiple sclerosis beyond damage to the RNFL and the ganglion cell layer (Green et al ., 2010). These data are intriguing in that they point to a novel concept of primary Retinal damage in multiple sclerosis. They indicate that Retinal Pathology might not only develop as a consequence of inflammatory attacks to the anterior optic pathway causing …
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Primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (
Orhan Aktas - One of the best experts on this subject based on the ideXlab platform.
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Retinal Pathology in idiopathic moyamoya angiopathy detected by optical coherence tomography
Neurology, 2015Co-Authors: Philipp Albrecht, Marius Ringelstein, Jens Harmel, Ann-kristin Müller, David Finis, Rainer Guthoff, Christine Blasberg, Sebastian Lukas, Ella-maria Kadas, Orhan AktasAbstract:Objective: To investigate whether patients with moyamoya angiopathy without obvious Retinal pathologies such as Retinal infarctions or the congenital morning glory anomaly may have subtle subclinical Retinal changes. Methods: In this cross-sectional study, spectral domain optical coherence tomography was used to analyze the Retinal morphology of 25 patients with idiopathic moyamoya angiopathy and 25 age- and sex-matched healthy controls. We analyzed the Retinal vasculature with blue laser autofluorescence, lipofuscin deposits with MultiColor confocal scanning laser ophthalmoscopy, and the optic nerve head (ONH) volume with a custom postprocessing algorithm. In addition to the total Retinal thickness, semiautomated segmentation was used for segmentation of Retinal layers in macular cross scans, macular volume scans, and peripapillary ring scans. Results: The main finding was a pronounced reduction of the ONH volume in moyamoya angiopathy compared with controls (0.76 ± 0.45 mm 3 and 1.47 ± 0.50 mm 3 , respectively; p 3 and 1.10 ± 0.10 mm 3 , respectively; p Conclusion: Our results indicate that even patients with moyamoya angiopathy who do not have obvious Retinal abnormalities have Retinal abnormalities. These can be detected by spectral domain optical coherence tomography, and the association of ONH abnormalities with the vascular changes may suggest that idiopathic moyamoya angiography is a systemic disease involving abnormalities of the early mesodermal development.
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Patterns of Retinal damage facilitate differential diagnosis between Susac syndrome and MS.
PLoS ONE, 2012Co-Authors: Alexander U Brandt, Marius Ringelstein, Orhan Aktas, Sven Schippling, David Finis, Hanna Zimmermann, Falko Kaufhold, Julia Promesberger, Christian Geis, E. Bernd RingelsteinAbstract:Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch Retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of Retinal structures and is increasingly established to depict characteristic patterns of Retinal Pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of Retinal Pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both Retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS.
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primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (<1st percentile). These in vivo findings are in line with a recent post-mortem analysis reporting Retinal Pathology in multiple sclerosis beyond damage to the RNFL and the ganglion cell layer (Green et al ., 2010). These data are intriguing in that they point to a novel concept of primary Retinal damage in multiple sclerosis. They indicate that Retinal Pathology might not only develop as a consequence of inflammatory attacks to the anterior optic pathway causing …
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Primary Retinal Pathology in multiple sclerosis as detected by optical coherence tomography
Brain, 2011Co-Authors: Alexander U Brandt, Timm Oberwahrenbrock, Marius Ringelstein, Kim Lea Young, M Tiede, H P Hartung, Roland Martin, Orhan Aktas, Friedemann Paul, Sven SchipplingAbstract:Sir, We read the recent Brain publication by Saidha et al. (2011) with great interest. In their manuscript, the authors suggested that primary Retinal Pathology detectable by optical coherence tomography (OCT) defines a subset of patients with multiple sclerosis (Saidha et al ., 2011). This subgroup of patients, which they termed ‘macular thinning predominant phenotype’, was reported to exist in ∼10% of the entire multiple sclerosis cohort examined by spectral domain OCT (Cirrus) at the authors’ centres. The macular thinning predominant OCT phenotype was defined by a combination of average macular thickness below the 5th percentile, with ipsilateral normal average Retinal nerve fibre layer (RNFL) thicknesses (between the 5th and 95th percentiles of RNFL values from the manufacturer's normative database), in one or both eyes, in the absence of a history of acute optic neuritis in affected eyes (Saidha et al ., 2011). Sixty-two per cent (31/50) of patients fulfilling the macular thinning predominant OCT criteria had a macular thickness below the 1st percentile. In addition, there was a remarkable male preponderance among patients with the macular thinning predominant phenotype (70% male versus 30% female), a difference that was even more pronounced (77.4% male versus 22.6% female) among those patients with very low macular thicknesses (