Progression of retinal ganglion cell loss in multiple sclerosis is associated with new lesions in the optic radiations

A. Klistorner*, E. C. Graham, C. Yiannikas, M. Barnett, J. Parratt, R. Garrick, C. Wang, Y. You, S. L. Graham

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Background and purpose: The mechanism of retinal ganglion cell and retinal nerve fiber layer loss in multiple sclerosis (MS) remains unknown. This study aimed to investigate the association between temporal retinal nerve fiber layer (tRNFL) thinning and disease activity in the brain determined by T2 lesions on magnetic resonance imaging (MRI). Methods: Fifty-five consecutive patients with relapsing-remitting MS and 25 controls were enrolled. All patients underwent annual optical coherence tomography and high-resolution MRI scans for tRNFL thickness and brain lesion volume analysis, respectively. Results: Significant tRNFL thickness reduction was observed over the 3-year follow-up period at a relatively constant rate (1.02 μm/year). Thinning of tRNFL fibers was more prominent in younger patients (P = 0.01). The tRNFL loss was associated with new MRI lesions in the optic radiations (ORs). There was significantly greater tRNFL thinning in patients with new lesional activity in the ORs compared with patients with new lesions outside the ORs (P = 0.009). Conclusions: This study supports the notion that retrograde transneuronal degeneration caused by OR lesions might play a role in progressive retinal nerve fiber layer loss. In addition, the results of the study also indicate that the disease-related neurodegenerative changes in the retina start much earlier than the clinical diagnosis of MS.

Original languageEnglish
Pages (from-to)1392–1398
Number of pages7
JournalEuropean Journal of Neurology
Issue number11
Publication statusPublished - Nov 2017


  • Magnetic resonance imaging
  • Multiple sclerosis
  • Optical coherence tomography
  • Retinal ganglion cell
  • Retinal nerve fiber layer


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