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Abstract #27524 Published in IGR 12-4
Cup to disc ratio by optical coherence tomography is abnormal inmultiple sclerosis
Syc SB; Warner CV; Farrell SK; Balcer LJ; Frohman EM; Calabresi PAMultiple Sclerosis 2010; 16: 1012
Background: The cup to disc ratio (CDR) has long been visually assessed by ophthalmologists for diagnosis and monitoring the progression of glaucoma, but is thought to be normal in patients with multiple sclerosis (MS). CDR can now be accurately quantifed using optical coherence tomography (OCT) allowing its assessment in other diseases in which peripapillary nerve fber layer loss could alter the ratio, such as in optic neuritis and MS. Objectives: To evaluate novel OCT measures, such as the CDR, using Cirrus HD-OCT (Carl Zeiss Meditec) in MS patients and healthy controls. Methods: The CDR, retinal nerve fber layer thickness (RNFLT), and total macular volume (TMV) were measured by the Cirrus HD-OCT in 40 MS patients and 40 healthy individuals. The number of letters correctly read at low-contrast visual acuity testing (2.5% and 1.25% contrast) was recorded for 23 individuals. Multivariate regression, accounting for age, gender, and history of optic neuritis, was used to assess the relationship between the CDR, RNFLT, TMV, and visual acuity scores. Results: The average age of the MS population was 38.5(plus or minus)1.6 years, while the average age for the control population was 37.9(plus or minus)1.6 years. The CDR ratio was greater in MS patients when compared to controls (b=0.088, p=0.027). There was an inverse relationship between CDR and RNFLT (b=-17.95, p=0.041) and TMV (b=-1.07, p=0.002). Individuals with a higher CDR identified significantly fewer letters correctly at 2.5% contrast (b=-29.87, p=0.043) and 1.25% contrast (b=-26.62, p=0.033). Conclusions: CDR is abnormal in MS and correlates with other OCT measures of nerve fber layer damage as well as with visual outcomes. CDR may provide another measure by which to monitor MS progression using OCT.
S.B. Syc. Department of Neurology, Johns Hopkins University, BaltimoreUnited States.
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
