Cup to disc ratio by optical coherence tomography is abnormal in multiple sclerosis

S. B. Syc, C. V. Warner, Shiv Saidha, S. K. Farrell, A. Conger, E. R. Bisker, J. Wilson, T. C. Frohman, E. M. Frohman, L. J. Balcer, Peter Calabresi

Research output: Contribution to journalArticle

Abstract

Objective: To identify and characterize cup to disc ratio (CDR) and related optic nerve head abnormalities in multiple sclerosis (MS) using spectral domain optical coherence tomography (OCT). Background: While CDR is routinely assessed by ophthalmologists in the evaluation of glaucoma, CDR and related optic nerve head metrics remain largely unexplored in MS. Design/methods: Cirrus-HD (high density) OCT was used to evaluate average CDR, vertical CDR, optic disc area, optic cup volume, and neuro-retinal rim area in 105 MS patients and 88 age-matched healthy individuals. High-contrast (100%) visual acuity, 2.5% low-contrast letter acuity and 1.25% low-contrast letter acuity were assessed in 77 MS patients. Two-sample t-tests were used in the analysis of OCT-derived optic nerve head measures between healthy controls and MS patients. Multivariate regression (accounting for age and gender) was used to assess relationships between optic nerve head measures and visual function. Results: Average CDR (p = 0.007) and vertical CDR (p = 0.005) were greater in MS patients compared to healthy controls, while neuro-retinal rim area was decreased in MS patients (p = 0.001). CDR increased with retinal nerve fiber layer (RNFL) thinning (r = -0.29, p = 0.001). 2.5% low-contrast (p = 0.005) and 1.25% low-contrast letter acuity (p = 0.03) were lower in MS patients with higher vertical CDR. Conclusions/relevance: CDR (as determined by spectral domain OCT) is abnormal in MS and correlates with visual function. OCT-derived CDR and related optic nerve head metrics may represent an objective measure by which to monitor disease progression, and potentially neuroprotection, in therapeutic MS trials.

Original languageEnglish (US)
Pages (from-to)19-24
Number of pages6
JournalJournal of the Neurological Sciences
Volume302
Issue number1-2
DOIs
StatePublished - Mar 15 2011

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Optical Coherence Tomography
Multiple Sclerosis
Optic Disk
Nerve Fibers
Glaucoma
Visual Acuity
Disease Progression

Keywords

  • Cup to disc ratio
  • Demyelinating disease
  • Multiple sclerosis
  • Neuro-ophthalmology
  • Optic nerve
  • Optic neuritis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Cup to disc ratio by optical coherence tomography is abnormal in multiple sclerosis. / Syc, S. B.; Warner, C. V.; Saidha, Shiv; Farrell, S. K.; Conger, A.; Bisker, E. R.; Wilson, J.; Frohman, T. C.; Frohman, E. M.; Balcer, L. J.; Calabresi, Peter.

In: Journal of the Neurological Sciences, Vol. 302, No. 1-2, 15.03.2011, p. 19-24.

Research output: Contribution to journalArticle

Syc, SB, Warner, CV, Saidha, S, Farrell, SK, Conger, A, Bisker, ER, Wilson, J, Frohman, TC, Frohman, EM, Balcer, LJ & Calabresi, P 2011, 'Cup to disc ratio by optical coherence tomography is abnormal in multiple sclerosis', Journal of the Neurological Sciences, vol. 302, no. 1-2, pp. 19-24. https://doi.org/10.1016/j.jns.2010.12.011
Syc, S. B. ; Warner, C. V. ; Saidha, Shiv ; Farrell, S. K. ; Conger, A. ; Bisker, E. R. ; Wilson, J. ; Frohman, T. C. ; Frohman, E. M. ; Balcer, L. J. ; Calabresi, Peter. / Cup to disc ratio by optical coherence tomography is abnormal in multiple sclerosis. In: Journal of the Neurological Sciences. 2011 ; Vol. 302, No. 1-2. pp. 19-24.
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abstract = "Objective: To identify and characterize cup to disc ratio (CDR) and related optic nerve head abnormalities in multiple sclerosis (MS) using spectral domain optical coherence tomography (OCT). Background: While CDR is routinely assessed by ophthalmologists in the evaluation of glaucoma, CDR and related optic nerve head metrics remain largely unexplored in MS. Design/methods: Cirrus-HD (high density) OCT was used to evaluate average CDR, vertical CDR, optic disc area, optic cup volume, and neuro-retinal rim area in 105 MS patients and 88 age-matched healthy individuals. High-contrast (100{\%}) visual acuity, 2.5{\%} low-contrast letter acuity and 1.25{\%} low-contrast letter acuity were assessed in 77 MS patients. Two-sample t-tests were used in the analysis of OCT-derived optic nerve head measures between healthy controls and MS patients. Multivariate regression (accounting for age and gender) was used to assess relationships between optic nerve head measures and visual function. Results: Average CDR (p = 0.007) and vertical CDR (p = 0.005) were greater in MS patients compared to healthy controls, while neuro-retinal rim area was decreased in MS patients (p = 0.001). CDR increased with retinal nerve fiber layer (RNFL) thinning (r = -0.29, p = 0.001). 2.5{\%} low-contrast (p = 0.005) and 1.25{\%} low-contrast letter acuity (p = 0.03) were lower in MS patients with higher vertical CDR. Conclusions/relevance: CDR (as determined by spectral domain OCT) is abnormal in MS and correlates with visual function. OCT-derived CDR and related optic nerve head metrics may represent an objective measure by which to monitor disease progression, and potentially neuroprotection, in therapeutic MS trials.",
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AU - Syc, S. B.

AU - Warner, C. V.

AU - Saidha, Shiv

AU - Farrell, S. K.

AU - Conger, A.

AU - Bisker, E. R.

AU - Wilson, J.

AU - Frohman, T. C.

AU - Frohman, E. M.

AU - Balcer, L. J.

AU - Calabresi, Peter

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N2 - Objective: To identify and characterize cup to disc ratio (CDR) and related optic nerve head abnormalities in multiple sclerosis (MS) using spectral domain optical coherence tomography (OCT). Background: While CDR is routinely assessed by ophthalmologists in the evaluation of glaucoma, CDR and related optic nerve head metrics remain largely unexplored in MS. Design/methods: Cirrus-HD (high density) OCT was used to evaluate average CDR, vertical CDR, optic disc area, optic cup volume, and neuro-retinal rim area in 105 MS patients and 88 age-matched healthy individuals. High-contrast (100%) visual acuity, 2.5% low-contrast letter acuity and 1.25% low-contrast letter acuity were assessed in 77 MS patients. Two-sample t-tests were used in the analysis of OCT-derived optic nerve head measures between healthy controls and MS patients. Multivariate regression (accounting for age and gender) was used to assess relationships between optic nerve head measures and visual function. Results: Average CDR (p = 0.007) and vertical CDR (p = 0.005) were greater in MS patients compared to healthy controls, while neuro-retinal rim area was decreased in MS patients (p = 0.001). CDR increased with retinal nerve fiber layer (RNFL) thinning (r = -0.29, p = 0.001). 2.5% low-contrast (p = 0.005) and 1.25% low-contrast letter acuity (p = 0.03) were lower in MS patients with higher vertical CDR. Conclusions/relevance: CDR (as determined by spectral domain OCT) is abnormal in MS and correlates with visual function. OCT-derived CDR and related optic nerve head metrics may represent an objective measure by which to monitor disease progression, and potentially neuroprotection, in therapeutic MS trials.

AB - Objective: To identify and characterize cup to disc ratio (CDR) and related optic nerve head abnormalities in multiple sclerosis (MS) using spectral domain optical coherence tomography (OCT). Background: While CDR is routinely assessed by ophthalmologists in the evaluation of glaucoma, CDR and related optic nerve head metrics remain largely unexplored in MS. Design/methods: Cirrus-HD (high density) OCT was used to evaluate average CDR, vertical CDR, optic disc area, optic cup volume, and neuro-retinal rim area in 105 MS patients and 88 age-matched healthy individuals. High-contrast (100%) visual acuity, 2.5% low-contrast letter acuity and 1.25% low-contrast letter acuity were assessed in 77 MS patients. Two-sample t-tests were used in the analysis of OCT-derived optic nerve head measures between healthy controls and MS patients. Multivariate regression (accounting for age and gender) was used to assess relationships between optic nerve head measures and visual function. Results: Average CDR (p = 0.007) and vertical CDR (p = 0.005) were greater in MS patients compared to healthy controls, while neuro-retinal rim area was decreased in MS patients (p = 0.001). CDR increased with retinal nerve fiber layer (RNFL) thinning (r = -0.29, p = 0.001). 2.5% low-contrast (p = 0.005) and 1.25% low-contrast letter acuity (p = 0.03) were lower in MS patients with higher vertical CDR. Conclusions/relevance: CDR (as determined by spectral domain OCT) is abnormal in MS and correlates with visual function. OCT-derived CDR and related optic nerve head metrics may represent an objective measure by which to monitor disease progression, and potentially neuroprotection, in therapeutic MS trials.

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KW - Demyelinating disease

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KW - Neuro-ophthalmology

KW - Optic nerve

KW - Optic neuritis

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