Sunday, 15 September 2013

Targeting retinal thinning may hold promise for Neuroprotection studies

Feng L, Shen J, Jin X, Li J, Li Y.The Evaluation of the Retinal Nerve Fiber Layer in Multiple Sclerosis with Special-Domain Optical Coherence Tomography.Ophthalmologica. 2013 Sep. [Epub ahead of print]

Background/Aims: Retinal nerve fiber layer (RNFL) thinning has been observed on histopathology and time-domain optical coherence tomography in many diseases of the central nervous system. In this study, with a higher resolution of spectral-domain optical coherence tomography (SDOCT), we detected RNFL changes in patients with multiple sclerosis (MS) in China, and compared RNFL thickness between eyes with and without optic neuritis (ON). Methods: In this retrospective, nonrandom case study, the patients were recruited from the Affiliated Sir Run Run Shaw Hospital of Zhejiang University. RNFL thickness was measured for each eye using SDOCT. The controls were recruited from the healthy population. Results: Peripapillary RNFL thickness of 24 eyes in 12 patients was detected by SDOCT. The average RNFL thickness of the MS patients was 81.9 ± 17.8 µm compared to the control value of 102.1 ± 8.1 µm (p = 0.00). The average RNFL of the patients with a history of ON was thinner than that of patients without ON (71.8 ± 19.2 µm vs. 92.0 ± 8.5 µm, p = 0.001). Conclusion: The RNFL thinning in Chinese patients with MS can be detected by SDOCT. The SDOCT scan represents a high-resolution, objective, noninvasive and easily quantifiable in vivo biomarker of MS

So it is clear that the retina of Msers is thinning compared to non-MSers and there is more thinning if the MSer had a history of MS. This study in Chinese MSers confirms that which has been found in North American and european MSers. This is due to nerve damage in the optic nerve tracking back into the eye. So targeting the visual pathway to look for neuroprotective drugs seems a good idea and this is being done as we speak in a few different trials

4 comments:

  1. I asked this question last month, but did not get an answer. Does retinal thinning occur in patients with high myopia? If so, can we assume that the study was done on people with the same optical prescription.

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  2. According to the web-High myopia may cause thinning and weakening of the retina (the thin membrane at the back of the eye that contains the rods and cones). Abnormal stretching or elongation of the eye may pull on the vitreous (the gel substance that fills the eye) which in turn pulls on the retina leading to its detachment.

    However whether this is the retinal nerve fibre layer compared to the photoreceptors I would need more reading. However I would suspect that the study was not done on people with the same optical prescription, but I do not have the paper to hand. But a good questions

    The problem in MS is not thought to be coming from the eye but from the optic nerve, the effects of die back from the optic nerve.

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  3. Thank you. The nurse photographed my retina twice, because she thought the machine wasn't working, as my retina is so thin. I was led to believe this was due to my myopia. I've always had pale discs, but this is the first time I've heard of the link with optic neuritis. This was a referral from my Optician, not a neurology clinic.

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  4. According to people at NIH, they are hopeful that this technique will be a sensitive measurement of progression. We need something better than EDSS, timed walks, etc. A big problem with SP/PPMS trials is finding a good, fast way to measure progression. If you need 5 years to follow progression in patients, that's a really expensive trial and means slow development of drug therapies for neuroprotection. Lots of work to do here.

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