Inner nuclear layer thickening is inversley proportional to retinal ganglion cell loss in optic neuritis

Megha Kaushik, Chen Yu Wang, Michael H. Barnett, Raymond Garrick, John Parratt, Stuart L. Graham, Prema Sriram, Con Yiannikas, Alexandr Klistorner*

*Corresponding author for this work

    Research output: Contribution to journalArticle

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    Abstract

    Aim: To examine the relationship between retinal ganglion cell loss and changes in the inner nuclear layer (INL) in optic neuritis (ON).

    Methods: 36 multiple sclerosis (MS) patients with a history of ON and 36 age and sex-matched controls underwent Optical Coherence Tomography. The paramacular retinal nerve fiber layer (RNFL), combined ganglion cell and inner plexiform layers (GCL/IPL) and inner nuclear layer (INL) thickness were measured at 36 points around the fovea. To remove inter-subject variability, the difference in thickness of each layer between the ON and fellow eye of each patient was calculated. A topographic analysis was conducted.

    Results: The INL of the ON patients was thicker than the controls (42.9μm versus 39.6μm, p=0.002). ON patients also had a thinner RNFL (27.8μm versus 32.2μm, p<0.001) and GCL/IPL (69.3μm versus 98.1μm, p<0.001). Among the controls, there was no correlation between RNFL and GCL/IPL as well as RNFL and INL, but a positive correlation was seen between GCL/IPL and INL (r=0.65, p<0.001). In the ON group, there was a positive correlation between RNFL and GCL/IPL (r=0.80, p<0.001) but a negative correlation between RNFL and INL (r=-0.61, p<0.001) as well as GCL/IPL and INL (r=-0.44, p=0.007). The negative correlation between GCL/IPL and INL strengthened in the ON group when inter-subject variability was removed (r=-0.75, p<0.001). Microcysts within the INL were present in 5 ON patients, mainly in the superior and infero-nasal paramacular regions. While patients with microcysts lay at the far end of the correlation curve between GCL/IPL and INL (i.e. larger INL and smaller GCL/IPL compared to other patients), their exclusion did not affect the correlation (r= -0.76, p<0.001).

    Conclusions: INL enlargement in MS-related ON is associated with the severity of GCL loss. This is a continuous relationship and patients with INL microcysts may represent the extreme end of the scale.

    Original languageEnglish
    Article numbere78341
    Pages (from-to)1-8
    Number of pages8
    JournalPLoS ONE
    Volume8
    Issue number10
    DOIs
    Publication statusPublished - 3 Oct 2013

    Bibliographical note

    Copyright the Author(s) 2013. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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