JAN 09, 2015
Neuro-Ophthalmology/Orbit
This editorial addressing a study published in the same journal issue posits that using OCT to study the retina in pediatric multiple sclerosis (MS) is essential for better understanding how the retina in these patients reacts to disease and treatment, the cause of MS, and how inflammation and degeneration are intertwined.
The study’s authors used high-resolution spectral-domain OCT (SD-OCT) to study the ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness in children with pediatric demyelinating disorders, 43% of whom had MS, and healthy controls.
What they found was different from what has been seen in adults: a disconnect between the number of optic neuritis (ON) episodes and GCL thickness. While the mean RNFL for the overall group was 26% lower compared to controls and declined by 9 µm per ON episode, in contrast the GCL did not decline with ON episodes, despite mean GCL being 20% reduced for the group compared to controls.
They suggest that this could be the case because a single ON episode could lead to substantial neuronal loss, thereby sparing very little for subsequent episodes to detect a change.
The editorial’s authors say these results should be interpreted with caution, given the cross-sectional nature of the study and a relatively small sample of non-ON eyes. They say that while this study is an important start, more definitive data will require larger studies, longitudinal follow-up and inclusion of brain MRIs.
They note that OCT is highly reproducible, quick to perform and offers an objective measure of neuronal damage. They say this could be critical in the pediatric population where subjective assessment of visual status could be unreliable.