Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study

Rachel C. Nolan-Kenney, Mengling Liu, Omar Akhand, Peter A. Calabresi, Friedemann Paul, Axel Petzold, Lisanne Balk, Alexander U. Brandt, Elena H. Martínez-Lapiscina, Shiv Saidha, Pablo Villoslada, Abdullah Abu Al-Hassan, Raed Behbehani, Elliot M. Frohman, Teresa Frohman, Joachim Havla, Bernhard Hemmer, Hong Jiang, Benjamin Knier, Thomas Korn & 7 others Letizia Leocani, Athina Papadopoulou, Marco Pisa, Hanna Zimmermann, Steven L. Galetta, Laura J. Balcer, on behalf of the International Multiple Sclerosis Visual System Consortium

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High- and low-contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. Results: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). Interpretation: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting. Ann Neurol 2019;85:618–629.
Original languageEnglish
Pages (from-to)618-629
JournalAnnals of Neurology
Volume85
Issue number5
DOIs
Publication statusPublished - 2019

Cite this

Nolan-Kenney, R. C., Liu, M., Akhand, O., Calabresi, P. A., Paul, F., Petzold, A., ... on behalf of the International Multiple Sclerosis Visual System Consortium (2019). Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study. Annals of Neurology, 85(5), 618-629. https://doi.org/10.1002/ana.25462
Nolan-Kenney, Rachel C. ; Liu, Mengling ; Akhand, Omar ; Calabresi, Peter A. ; Paul, Friedemann ; Petzold, Axel ; Balk, Lisanne ; Brandt, Alexander U. ; Martínez-Lapiscina, Elena H. ; Saidha, Shiv ; Villoslada, Pablo ; Al-Hassan, Abdullah Abu ; Behbehani, Raed ; Frohman, Elliot M. ; Frohman, Teresa ; Havla, Joachim ; Hemmer, Bernhard ; Jiang, Hong ; Knier, Benjamin ; Korn, Thomas ; Leocani, Letizia ; Papadopoulou, Athina ; Pisa, Marco ; Zimmermann, Hanna ; Galetta, Steven L. ; Balcer, Laura J. ; on behalf of the International Multiple Sclerosis Visual System Consortium. / Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study. In: Annals of Neurology. 2019 ; Vol. 85, No. 5. pp. 618-629.
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title = "Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study",
abstract = "Objective: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High- and low-contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. Results: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). Interpretation: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting. Ann Neurol 2019;85:618–629.",
author = "Nolan-Kenney, {Rachel C.} and Mengling Liu and Omar Akhand and Calabresi, {Peter A.} and Friedemann Paul and Axel Petzold and Lisanne Balk and Brandt, {Alexander U.} and Mart{\'i}nez-Lapiscina, {Elena H.} and Shiv Saidha and Pablo Villoslada and Al-Hassan, {Abdullah Abu} and Raed Behbehani and Frohman, {Elliot M.} and Teresa Frohman and Joachim Havla and Bernhard Hemmer and Hong Jiang and Benjamin Knier and Thomas Korn and Letizia Leocani and Athina Papadopoulou and Marco Pisa and Hanna Zimmermann and Galetta, {Steven L.} and Balcer, {Laura J.} and {on behalf of the International Multiple Sclerosis Visual System Consortium}",
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Nolan-Kenney, RC, Liu, M, Akhand, O, Calabresi, PA, Paul, F, Petzold, A, Balk, L, Brandt, AU, Martínez-Lapiscina, EH, Saidha, S, Villoslada, P, Al-Hassan, AA, Behbehani, R, Frohman, EM, Frohman, T, Havla, J, Hemmer, B, Jiang, H, Knier, B, Korn, T, Leocani, L, Papadopoulou, A, Pisa, M, Zimmermann, H, Galetta, SL, Balcer, LJ & on behalf of the International Multiple Sclerosis Visual System Consortium 2019, 'Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study' Annals of Neurology, vol. 85, no. 5, pp. 618-629. https://doi.org/10.1002/ana.25462

Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study. / Nolan-Kenney, Rachel C.; Liu, Mengling; Akhand, Omar; Calabresi, Peter A.; Paul, Friedemann; Petzold, Axel; Balk, Lisanne; Brandt, Alexander U.; Martínez-Lapiscina, Elena H.; Saidha, Shiv; Villoslada, Pablo; Al-Hassan, Abdullah Abu; Behbehani, Raed; Frohman, Elliot M.; Frohman, Teresa; Havla, Joachim; Hemmer, Bernhard; Jiang, Hong; Knier, Benjamin; Korn, Thomas; Leocani, Letizia; Papadopoulou, Athina; Pisa, Marco; Zimmermann, Hanna; Galetta, Steven L.; Balcer, Laura J.; on behalf of the International Multiple Sclerosis Visual System Consortium.

In: Annals of Neurology, Vol. 85, No. 5, 2019, p. 618-629.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Optimal intereye difference thresholds by optical coherence tomography in multiple sclerosis: An international study

AU - Nolan-Kenney, Rachel C.

AU - Liu, Mengling

AU - Akhand, Omar

AU - Calabresi, Peter A.

AU - Paul, Friedemann

AU - Petzold, Axel

AU - Balk, Lisanne

AU - Brandt, Alexander U.

AU - Martínez-Lapiscina, Elena H.

AU - Saidha, Shiv

AU - Villoslada, Pablo

AU - Al-Hassan, Abdullah Abu

AU - Behbehani, Raed

AU - Frohman, Elliot M.

AU - Frohman, Teresa

AU - Havla, Joachim

AU - Hemmer, Bernhard

AU - Jiang, Hong

AU - Knier, Benjamin

AU - Korn, Thomas

AU - Leocani, Letizia

AU - Papadopoulou, Athina

AU - Pisa, Marco

AU - Zimmermann, Hanna

AU - Galetta, Steven L.

AU - Balcer, Laura J.

AU - on behalf of the International Multiple Sclerosis Visual System Consortium

PY - 2019

Y1 - 2019

N2 - Objective: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High- and low-contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. Results: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). Interpretation: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting. Ann Neurol 2019;85:618–629.

AB - Objective: To determine the optimal thresholds for intereye differences in retinal nerve fiber and ganglion cell + inner plexiform layer thicknesses for identifying unilateral optic nerve lesions in multiple sclerosis. Current international diagnostic criteria for multiple sclerosis do not include the optic nerve as a lesion site despite frequent involvement. Optical coherence tomography detects retinal thinning associated with optic nerve lesions. Methods: In this multicenter international study at 11 sites, optical coherence tomography was measured for patients and healthy controls as part of the International Multiple Sclerosis Visual System Consortium. High- and low-contrast acuity were also collected in a subset of participants. Presence of an optic nerve lesion for this study was defined as history of acute unilateral optic neuritis. Results: Among patients (n = 1,530), receiver operating characteristic curve analysis demonstrated an optimal peripapillary retinal nerve fiber layer intereye difference threshold of 5μm and ganglion cell + inner plexiform layer threshold of 4μm for identifying unilateral optic neuritis (n = 477). Greater intereye differences in acuities were associated with greater intereye retinal layer thickness differences (p ≤ 0.001). Interpretation: Intereye differences of 5μm for retinal nerve fiber layer and 4μm for macular ganglion cell + inner plexiform layer are robust thresholds for identifying unilateral optic nerve lesions. These thresholds may be useful in establishing the presence of asymptomatic and symptomatic optic nerve lesions in multiple sclerosis and could be useful in a new version of the diagnostic criteria. Our findings lend further validation for utilizing the visual system in a multiple sclerosis clinical trial setting. Ann Neurol 2019;85:618–629.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/30851125

U2 - 10.1002/ana.25462

DO - 10.1002/ana.25462

M3 - Article

VL - 85

SP - 618

EP - 629

JO - Annals of Neurology

JF - Annals of Neurology

SN - 0364-5134

IS - 5

ER -