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Aly L, Strauß EM, Feucht N, Weiß I, Berthele A, Mitsdoerffer M, Haass C, Hemmer B, Maier M, Korn T, Knier B. Optical coherence tomography angiography indicates subclinical retinal disease in neuromyelitis optica spectrum disorders. Mult Scler 2021; 28:522-531. [PMID: 34259579 PMCID: PMC8961243 DOI: 10.1177/13524585211028831] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Neuromyelitis optica spectrum disorders (NMOSD) are neuroinflammatory
diseases of the central nervous system. Patients suffer from recurring
relapses and it is unclear whether relapse-independent disease activity
occurs and whether this is of clinical relevance. Objective: To detect disease-specific alterations of the retinal vasculature that
reflect disease activity during NMOSD. Methods: Cross-sectional analysis of 16 patients with NMOSD, 21 patients with
relapsing-remitting multiple sclerosis, and 21 healthy controls using
retinal optical coherence tomography (OCT), optical coherence tomography
angiography (OCT-A), measurement of glial fibrillary acidic protein (GFAP)
serum levels, and assessment of visual acuity. Results: Patients with NMOSD but not multiple sclerosis revealed lower foveal
thickness (FT) (p = 0.02) measures and an increase of the
foveal avascular zone (FAZ) (p = 0.02) compared to healthy
controls independent to optic neuritis. Reduced FT (p =
0.01), enlarged FAZ areas (p = 0.0001), and vessel loss of
the superficial vascular complex (p = 0.01) were linked to
higher serum GFAP levels and superficial vessel loss was associated with
worse visual performance in patients with NMOSD irrespective of optic
neuritis. Conclusion: Subclinical parafoveal retinal vessel loss might occur during NMOSD and might
be linked to astrocyte damage and poor visual performance. OCT-A may be a
tool to study subclinical disease activity during NMOSD.
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Affiliation(s)
- Lilian Aly
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Institute for Experimental Neuroimmunology, Technical University of Munich, Munich, Germany
| | - Eva-Maria Strauß
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Institute for Experimental Neuroimmunology, Technical University of Munich, Munich, Germany
| | - Nikolaus Feucht
- Department of Ophthalmology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Airport Munich Eyeclinic MVZ, Munich, Germany
| | - Isabella Weiß
- Department of Ophthalmology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Achim Berthele
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Meike Mitsdoerffer
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Institute for Experimental Neuroimmunology, Technical University of Munich, Munich, Germany
| | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany/Institute of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Bernhard Hemmer
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mathias Maier
- Department of Ophthalmology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Korn
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Institute for Experimental Neuroimmunology, Technical University of Munich, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Benjamin Knier
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Institute for Experimental Neuroimmunology, Technical University of Munich, Munich, Germany
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