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Abstract
Objective To explore sensitivity of optical coherence tomography (OCT) in detecting prior unilateral optic neuritis.
Methods This is a retrospective, observational clinical study of all patients who presented from January 1, 2014, to January 6, 2017, with unilateral optic neuritis and OCT available at least 3 months after the attack. We compared OCT retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses between affected and unaffected contralateral eyes. We excluded patients with concomitant glaucoma or other optic neuropathies. Based on analysis of normal controls, thinning was considered significant if RNFL was at least 9 µm or GCIPL was at least 6 µm less in the affected eye compared to the unaffected eye.
Results Fifty-one patients (18 male and 33 female) were included in the study. RNFL and GCIPL thicknesses were significantly lower in eyes with optic neuritis compared to unaffected eyes (p < 0.001). RNFL was thinner by ≥9 µm in 73% of optic neuritis eyes compared to the unaffected eye. GCIPL was thinner by ≥6 µm in 96% of optic neuritis eyes, which was more sensitive than using RNFL (p < 0.001). When using a threshold ≤1st percentile of age-matched controls, sensitivities were 37% for RNFL and 76% for GCIPL, each of which was lower than those calculated using the intereye difference as the threshold (p < 0.01).
Conclusions OCT, especially with GCIPL analysis, is a highly sensitive modality in detecting prior optic neuritis, which is made more robust by using intereye differences to approximate change.
Classification of evidence This study provides Class III evidence that OCT accurately identifies patients with prior unilateral optic neuritis.
Glossary
- GCIPL=
- ganglion cell–inner plexiform layer;
- MOG=
- myelin oligodendrocyte glycoprotein;
- MS=
- multiple sclerosis;
- NMOSD=
- neuromyelitis optica spectrum disorder;
- OCT=
- optical coherence tomography;
- RAPD=
- relative afferent pupil defect;
- RNFL=
- retinal nerve fiber layer;
- TBI=
- traumatic brain injury;
- VEP=
- visual evoked potential
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial page 253
Class of Evidence: NPub.org/coe
- Received March 23, 2018.
- Accepted in final form December 6, 2018.
- © 2019 American Academy of Neurology
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