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Lambiri DW, Levin LA. Maculopapillary Bundle Degeneration in Optic Neuropathies. Curr Neurol Neurosci Rep 2024; 24:203-218. [PMID: 38833037 DOI: 10.1007/s11910-024-01343-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE OF REVIEW Degeneration of the maculopapillary bundle (MPB) is a prominent feature in a spectrum of optic neuropathies. MPB-selective degeneration is seen in specific conditions, such as nutritional and toxic optic neuropathies, Leber hereditary optic neuropathy (LHON), and dominant optic atrophy (DOA). Despite their distinct etiologies and clinical presentations, which encompass variations in age of incidence and monocular or binocular onset, these disorders share a core molecular mechanism: compromised mitochondrial homeostasis. This disruption is characterized by dysfunctions in mitochondrial metabolism, biogenesis, and protein synthesis. This article provides a comprehensive understanding of the MPB's role in optic neuropathies, emphasizing the importance of mitochondrial mechanisms in the pathogenesis of these conditions. RECENT FINDINGS Optical coherence tomography studies have characterized the retinal nerve fiber layer changes accompanying mitochondrial-affiliated optic neuropathies. Selective thinning of the temporal optic nerve head is preceded by thickening in early stages of these disorders which correlates with reductions in macular ganglion cell layer thinning and vascular atrophy. A recently proposed mechanism underpinning the selective atrophy of the MPB involves the positive feedback of reactive oxygen species generation as a common consequence of mitochondrial dysfunction. Additionally, new research has revealed that the MPB can undergo degeneration in the early stages of glaucoma, challenging the historically held belief that this area was not involved in this common optic neuropathy. A variety of anatomical risk factors influence the propensity of glaucomatous MPB degeneration, and cases present distinct patterns of ganglion cell degeneration that are distinct from those observed in mitochondria-associated diseases. This review synthesizes clinical and molecular research on primary MPB disorders, highlighting the commonalities and differences in their pathogenesis. KEY POINTS (BOX) 1. Temporal degeneration of optic nerve fibers accompanied by cecocentral scotoma is a hallmark of maculopapillary bundle (MPB) degeneration. 2. Mechanisms of MPB degeneration commonly implicate mitochondrial dysfunction. 3. Recent research challenges the traditional belief that the MPB is uninvolved in glaucoma by showing degeneration in the early stages of this common optic neuropathy, yet with features distinct from other MPB-selective neuropathies. 4. Reactive oxygen species generation is a mechanism linking mitochondrial mechanisms of MPB-selective optic neuropathies, but in-vivo and in-vitro studies are needed to validate this hypothesis.
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Affiliation(s)
- Darius W Lambiri
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, Canada
| | - Leonard A Levin
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, Canada.
- Department of Neurology & Neurosurgery, McGill University, Montreal, Canada.
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Taskiran-Sag A, Yazgi H, Ozulken K, Eroglu E. Optical coherence tomography findings in primary headache disorders: is pain duration a clinical correlate? Int J Neurosci 2024:1-7. [PMID: 38768056 DOI: 10.1080/00207454.2024.2358367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 05/11/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE Ganglion cell layer thickness (GCLT) may be used as a potential marker for central neural changes. We compared GCLT by using spectral domain optical coherence tomography (SD-OCT) in patients with primary headache disorders and healthy controls. We seek whether there was any difference between the headache groups and whether any clinical parameters correlated to GCLT. METHODS Fifty-three primary headache patients, 11 age and sex-matched healthy subjects were included in this cross-sectional study after power analysis. All subjects underwent SD-OCT. The duration of disorder, headache frequency, severity, duration of pain, presence of ocular pain, and accompanying symptoms have been collected. RESULTS Mean GCLT of the headache group was 15.7 ± 3.8 µm (mean ± standard deviation), and the control group was 17.5 ± 2.4. The difference was not statistically significant. When we compared the controls, migraine and tension-type headache patients' GCLT values, we found a significant difference (ANOVA, p = 0.001). Migraine patients had thinner GCLT compared to all non-migraine headache patients (p = 0.01). Intraocular pressure values of migraine patients and non-migraine patients were not statistically significantly different (p = 0.13). The only clinical parameter that correlated with GCLT was pain duration (r = -0.43 and p = 0.01). The patients with white matter lesions had thinner GCLT (p = 0.046). CONCLUSION Our results suggest that not long-term suffering from pain but migraine pathophysiology itself seems to affect neuroretinal tissue. Pain duration was moderately and inversely correlated to GCLT, meaning that the longer the headache, the thinner the ganglion cell layer is.
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Affiliation(s)
- Aslihan Taskiran-Sag
- Department of Neurology, Faculty of Medicine, TOBB Economics and Technology University, Ankara, Turkey
| | - Hare Yazgi
- Faculty of Medicine, TOBB Economics and Technology University, Ankara, Turkey
| | - Kemal Ozulken
- Department of Ophthalmology, Faculty of Medicine, TOBB Economics and Technology University, Ankara, Turkey
| | - Erdal Eroglu
- Department of Neurology, Faculty of Medicine, TOBB Economics and Technology University, Ankara, Turkey
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Chaliha DR, Vaccarezza M, Charng J, Chen FK, Lim A, Drummond P, Takechi R, Lam V, Dhaliwal SS, Mamo JCL. Using optical coherence tomography and optical coherence tomography angiography to delineate neurovascular homeostasis in migraine: a review. Front Neurosci 2024; 18:1376282. [PMID: 38686331 PMCID: PMC11057254 DOI: 10.3389/fnins.2024.1376282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
Migraine is one of the world's most debilitating disorders, and it has recently been shown that changes in the retina can be a potential biomarker for the disease. These changes can be detected by optical coherence tomography (OCT), which measures retinal thickness, and optical coherence tomography angiography (OCTA), which measures vessel density. We searched the databases Google Scholar, ProQuest, Scopus, and Web of Science for studies in English using OCT and OCTA in migraineurs, using the search terms "optical coherence tomography," "OCT," "optical coherence tomography angiography," "OCTA" and "migraine." We found 73 primary studies, 11 reviews, and 8 meta-analyses pertaining to OCT and OCTA findings in migraineurs. They showed that migraineurs had reduced retinal thickness (via OCT), retinal vessel density, and greater foveal avascular zone area (via OCTA) than controls. OCTA changes reflect a perfusion compromise occurring in migraineurs as opposed to in healthy controls. OCT and OCTA deficits were worse in migraine-with-aura and chronic migraine than in migraine-without-aura and episodic migraine. Certain areas of the eye, such as the fovea, may be more vulnerable to these perfusion changes than other parts. Direct comparison between study findings is difficult because of the heterogeneity between the studies in terms of both methodology and analysis. Moreover, as almost all case-control studies were cross-sectional, more longitudinal cohort studies are needed to determine cause and effect between migraine pathophysiology and OCT/OCTA findings. Current evidence suggests both OCT and OCTA may serve as retinal markers for migraineurs, and further research in this field will hopefully enable us to better understand the vascular changes associated with migraine, perhaps also providing a new diagnostic and therapeutic biomarker.
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Affiliation(s)
- Devahuti R. Chaliha
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
| | - Mauro Vaccarezza
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Sciences (Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Sciences (Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Amy Lim
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, Australia
| | - Peter Drummond
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Ryusuke Takechi
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- Perron Institute Neurological and Translational Sciences, Perth, WA, Australia
| | - Virginie Lam
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- Perron Institute Neurological and Translational Sciences, Perth, WA, Australia
| | - Satvinder S. Dhaliwal
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Singapore University of Social Sciences, Singapore, Singapore
| | - John C. L. Mamo
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- Perron Institute Neurological and Translational Sciences, Perth, WA, Australia
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Agapito Tito CV, Silvatti J, de Almeida INF, Taniguchi EV, Prata TS, Paranhos A, Kayser C. Structural abnormalities associated with glaucoma using swept-source optical coherence tomography in patients with systemic sclerosis. Int Ophthalmol 2021; 42:1369-1380. [PMID: 34822051 DOI: 10.1007/s10792-021-02124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Vasospasm represents an early event in systemic sclerosis (SSc). Ocular vasospasm may induce optic nerve head (ONH) damage and has been involved in the pathogenesis of glaucoma, especially normal-tension glaucoma (NTG). We aimed to investigate the presence of structural abnormalities associated with NTG using swept-source optical coherence tomography (SS-OCT) and to correlate the OCT parameters with clinical, capillaroscopy and digital blood flow measures in patients with SSc. METHODS In this cross-sectional study, 40 patients with SSc and 23 age-matched controls were included. The following parameters were measured using SS-OCT: mean and sectoral retinal nerve fibre layer (RNFL) thickness, macular ganglion cell layer complex (GCC) thickness and ONH morphology. Nailfold capillaroscopy (NFC) and digital blood flow measurements using laser Doppler imaging (LDI) were performed in all subjects. RESULTS Patients with SSc showed a thinner temporal RNFL than the controls (69.23 ± 11.74 versus 83.35 ± 20.19 µm, p = 0.001). The other parameters were similar between the two groups. In SSc patients, there was an inverse correlation between the disease duration and the average, superior and inferior RNFL thickness and the GCC thickness and between Raynaud's phenomenon duration and the average RNFL and GCC thickness (p < 0.05). NFC and LDI measurements did not show correlations with OCT parameters. CONCLUSION A thinner temporal RNFL and the correlation between Raynaud's phenomenon and disease duration and structural abnormalities on OCT suggest the presence of early ganglion cell damage in patients with SSc. Although mild, these findings indicate the need to monitor ocular abnormalities in SSc.
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Affiliation(s)
- Cecilia Victoria Agapito Tito
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu 740, 3° andar, São Paulo, SP, 04023-062, Brazil
| | - Juliana Silvatti
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu 740, 3° andar, São Paulo, SP, 04023-062, Brazil
| | - Izabela N F de Almeida
- Department of Ophthalmology and Visual Science, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elise V Taniguchi
- Department of Ophthalmology and Visual Science, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tiago S Prata
- Department of Ophthalmology and Visual Science, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Augusto Paranhos
- Department of Ophthalmology and Visual Science, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Cristiane Kayser
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu 740, 3° andar, São Paulo, SP, 04023-062, Brazil.
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Pearson SM, Burish MJ, Shapiro RE, Yan Y, Schor LI. Effectiveness of Oxygen and Other Acute Treatments for Cluster Headache: Results From the Cluster Headache Questionnaire, an International Survey. Headache 2019; 59:235-249. [PMID: 30632614 PMCID: PMC6590636 DOI: 10.1111/head.13473] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the effectiveness and adverse effects of acute cluster headache medications in a large international sample, including recommended treatments such as oxygen, commonly used medications such as opioids, and emerging medications such as intranasal ketamine. Particular focus is paid to a large subset of respondents 65 years of age or older. BACKGROUND Large international surveys of cluster headache are rare, as are examinations of treatments and side effects in older cluster headache patients. This article presents data from the Cluster Headache Questionnaire, with respondents from over 50 countries and with the vast majority from the United States, the United Kingdom, and Canada. METHODS This internet-based survey included questions on cluster headache diagnostic criteria, which were used as part of the inclusion/exclusion criteria for the study, as well as effectiveness of medications, physical and medical complications, psychological and emotional complications, mood scores, and difficulty obtaining medications. The diagnostic questions were also used to create a separate group of respondents with probable cluster headache. Limitations to the methods include the use of nonvalidated questions, the lack of a formal clinical diagnosis of cluster headache, and the grouping of some medications (eg, all triptans as opposed to sumatriptan subcutaneous alone). RESULTS A total of 3251 subjects participated in the questionnaire, and 2193 respondents met criteria for this study (1604 cluster headache and 589 probable cluster headache). Of the respondents with cluster headache, 68.8% (1104/1604) were male and 78.0% (1245/1596) had episodic cluster headache. Over half of respondents reported complete or very effective treatment for triptans (54%, 639/1139) and oxygen (54%, 582/1082). Between 14 and 25% of respondents reported complete or very effective treatment for ergot derivatives (dihydroergotamine 25%, 42/170; cafergot/ergotamine 17%, 50/303), caffeine and energy drinks (17%, 7/41), and intranasal ketamine (14%, 5/37). Less than 10% reported complete or very effective treatment for opioids (6%, 30/541), intranasal capsaicin (5%, 7/151), and intranasal lidocaine (2%, 5/241). Adverse events were especially low for oxygen (no or minimal physical and medical complications 99%, 1077/1093; no or minimal psychological and emotional complications 97%, 1065/1093), intranasal lidocaine (no or minimal physical and medical complications 97%, 248/257; no or minimal psychological and emotional complications 98%, 251/257), intranasal ketamine (no or minimal physical and medical complications 95%, 38/40; no or minimal psychological and emotional complications 98%, 39/40), intranasal capsaicin (no or minimal physical and medical complications 91%, 145/159; no or minimal psychological and emotional complications 94%, 150/159), and caffeine and energy drinks (no or minimal physical and medical complications 89%, 39/44; no or minimal psychological and emotional complications 91%, 40/44). This is in comparison to ergotamine/cafergot (no or minimal physical and medical complications 83%, 273/327; no or minimal psychological and emotional complications 89%, 290/327), dihydroergotamine (no or minimal physical and medical complications 81%, 143/176; no or minimal psychological and emotional complications 91%, 160/176), opioids (no or minimal physical and medical complications 76%, 416/549; no or minimal psychological and emotional complications 77%, 423/549), or triptans (no or minimal physical and medical complications 73%, 883/1218; no or minimal psychological and emotional complications 85%, 1032/1218). A total of 139 of 1604 cluster headache respondents (8.7%) were age 65 and older and reported similar effectiveness and adverse events to the general population. The 589 respondents with probable cluster headache reported similar medication effectiveness to respondents with a full diagnosis of cluster headache. CONCLUSIONS Oxygen is reported by survey respondents to be a highly effective treatment with few complications in cluster headache in a large international sample, including those 65 years or over. Triptans are also very effective with some side effects, and newer medications deserve additional study. Patients with probable cluster headache may respond similarly to acute medications as patients with a full diagnosis of cluster headache.
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Affiliation(s)
| | - Mark J. Burish
- Department of NeurosurgeryUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Robert E. Shapiro
- Department of Neurological SciencesUniversity of VermontBurlingtonVTUSA
| | - Yuanqing Yan
- Department of NeurosurgeryUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Larry I. Schor
- Department of PsychologyUniversity of West GeorgiaCarrolltonGAUSA
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Oertel FC, Zimmermann HG, Brandt AU, Paul F. Novel uses of retinal imaging with optical coherence tomography in multiple sclerosis. Expert Rev Neurother 2018; 19:31-43. [PMID: 30587061 DOI: 10.1080/14737175.2019.1559051] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Multiple Sclerosis (MS) is the most common chronic autoimmune neuroinflammatory condition in young adults. It is often accompanied by optic neuritis (ON) and retinal neuro-axonal damage causing visual disturbances. Optical coherence tomography (OCT) is a sensitive non-invasive method for quantifying intraretinal layer volumes. Recently, OCT not only showed to be a reliable marker for ON-associated damage, but also proved its high prognostic value for functional outcome and disability accrual in patients with MS. Consequently, OCT is discussed as a potential marker for monitoring disease severity and therapeutic response in individual patients. Areas covered: This article summarizes our current understanding of structural retinal changes in MS and describes the future potential of OCT for differential diagnosis, monitoring of the disease course and for clinical trials. Expert commentary: Today, OCT is used in clinical practice in specialized MS centers. Standardized parameters across devices are urgently needed for supporting clinical utility. Novel parameters are desirable to increase sensitivity and specificity in terms of MS.
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Affiliation(s)
- Frederike C Oertel
- a NeuroCure Clinical Research Center , Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany
| | - Hanna G Zimmermann
- a NeuroCure Clinical Research Center , Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany
| | - Alexander U Brandt
- a NeuroCure Clinical Research Center , Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany.,b Department of Neurology , University of California Irvine , Irvine , CA , USA
| | - Friedemann Paul
- a NeuroCure Clinical Research Center , Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany.,c Department of Neurology , Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany.,d Experimental and Clinical Research Center , Max-Delbrück-Centrum für Molekulare Medizin and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany
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Garcia-Martin E, Ruiz-de Gopegui E, León-Latre M, Otin S, Altemir I, Polo V, Larrosa JM, Cipres M, Casasnovas JA, Pablo LE. Influence of cardiovascular condition on retinal and retinal nerve fiber layer measurements. PLoS One 2017; 12:e0189929. [PMID: 29272287 PMCID: PMC5741228 DOI: 10.1371/journal.pone.0189929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess changes in the retinal nerve fiber layer (RNFL) and macula in subjects with cardiovascular risk factors or subclinical ischemia. DESIGN Prospective and observational study. METHODS A total of 152 healthy men underwent cardiovascular examination, including quantification of subclinical atheroma plaques by artery ultrasound scans, blood analysis, and a complete ophthalmic evaluation, including spectral-domain optical coherence tomography. The variables registered in cardiovascular examination were quantification of classic major risk factors, subclinical atheroma plaques by artery ultrasound scans, and analytical records. The ophthalmic evaluation registered RNFL and macular thickness. RESULTS Mean subject age was 51.27±3.71 years. The 40 subjects without classic cardiovascular risk factors did not show differences in RNFL and macular thicknesses compared with the 112 subjects with at least one risk factor (except in sector 9 that showed higher thicknesses in subjects with ≥1 risk factor). Comparison between the group of subjects with and without atheroma plaques revealed no differences in RNFL and macular thicknesses. The sub-analysis of subjects with subclinical atheroma plaques in the common carotid artery revealed a significant reduction in central macular thickness in the left eye compared with the right eye (p = 0.016), RNFL in the superior quadrant (p = 0.007), and the 11 o'clock sector (p = 0.020). Comparison between smokers and nonsmokers revealed that smokers had significant thinning of the central macular thickness (p = 0.034), the nasal RNFL quadrant (p = 0.006), and the 3 and 5 o'clock sectors (p = 0.016 and 0.009). CONCLUSIONS Classic cardiovascular risk factors do not cause RNFL or macular thickness reduction, but tobacco smoking habit reduces nasal RNFL thickness. Subclinical atherosclerosis in the common carotid artery associates a reduction in central macular and nasal RNFL quadrant thicknesses in the left eye compared with the right eye.
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Affiliation(s)
- Elena Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Erika Ruiz-de Gopegui
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Montserrat León-Latre
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
- Health Center La Jota, Aragon Health Service, Zaragoza, Spain
| | - Sofia Otin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Irene Altemir
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Vicente Polo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Jose M. Larrosa
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Marta Cipres
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Jose A. Casasnovas
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
- Department of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Luis E. Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
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Birkeldh U, Manouchehrinia A, Hietala MA, Hillert J, Olsson T, Piehl F, Kockum IS, Brundin L, Zahavi O, Wahlberg-Ramsay M, Brautaset R, Nilsson M. The Temporal Retinal Nerve Fiber Layer Thickness Is the Most Important Optical Coherence Tomography Estimate in Multiple Sclerosis. Front Neurol 2017; 8:675. [PMID: 29326643 PMCID: PMC5733353 DOI: 10.3389/fneur.2017.00675] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/28/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Reduced peripapillary retinal nerve fiber layer (pRNFL) and combined ganglion cell and inner plexiform layer (GCIP) thicknesses as measured by optical coherence tomography (OCT) have been observed in multiple sclerosis (MS) patients. The purpose was to determine the most associative OCT measure to level of cognitive and physical disability in MS. METHODS Data were collected from 546 MS patients and 175 healthy controls (HCs). We compared the average pRNFL, temporal pRNFL (T-pRNFL), overall inner ganglion cell/inner plexiform layer (GCIP), and the overall ganglion cell complex (GCC) including macular RNFL and GCIP thicknesses measurements in differentiating MS subtypes from HCs. The association between OCT measures, Expanded Disability Status Scale (EDSS), and Symbol Digit Modalities Test (SDMT) were assessed using generalized estimating equations models. RESULTS Both peripapillary and macular OCT measurements could differentiate all MS subtypes from HCs. The SDMT score was significantly associated with reduced thickness of all OCT measures, mostly in average pRNFL (0.14 µm, P = 0.001) and T-pRNFL (0.17 µm, P < 0.001). The EDSS score was significantly associated with reduced inner retinal layer thickness. The largest reduction was seen in T-pRNFL (-1.52 μm, P < 0.001) and inner GCC (-1.78 μm, P < 0.001). CONCLUSION The T-pRNFL is highly sensitive and associated with level of both cognitive and physical disability.
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Affiliation(s)
- Ulrika Birkeldh
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden
| | - Ali Manouchehrinia
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Max Albert Hietala
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Fredrik Piehl
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Ingrid Skelton Kockum
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Lou Brundin
- Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden
| | - Ori Zahavi
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden
| | - Marika Wahlberg-Ramsay
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden
| | - Rune Brautaset
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden
| | - Maria Nilsson
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden
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Ofte HK, von Hanno T, Alstadhaug KB. Retinal vasculature in cluster headache. Cephalalgia 2017; 37:197-198. [DOI: 10.1177/0333102416642428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Therese von Hanno
- Nordland Hospital Trust, Bodø, Norway
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Karl B Alstadhaug
- Nordland Hospital Trust, Bodø, Norway
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
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Reggio E, Chisari CG, Ferrigno G, Patti F, Donzuso G, Sciacca G, Avitabile T, Faro S, Zappia M. Migraine causes retinal and choroidal structural changes: evaluation with ocular coherence tomography. J Neurol 2016; 264:494-502. [DOI: 10.1007/s00415-016-8364-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 01/03/2023]
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Cameron JR, Tatham AJ. A window to beyond the orbit: the value of optical coherence tomography in non-ocular disease. Acta Ophthalmol 2016; 94:533-9. [PMID: 26803923 DOI: 10.1111/aos.12978] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/29/2015] [Indexed: 12/12/2022]
Abstract
Optical coherence tomography (OCT) imaging of the eye has become an essential tool for the ophthalmologist, aiding diagnosis and assisting with treatment decisions, in many ocular diseases. However, there is an evolving role for OCT in informing on non-ocular diseases, which ophthalmologists should be aware of. The purpose of this review was to examine recent evidence for the role of ocular OCT imaging to evaluate disease beyond the orbit and to discuss possible opportunities and challenges arising from this, from the perspective of the ophthalmologist.
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Affiliation(s)
- James R. Cameron
- Anne Rowling Regenerative Neurology Clinic; University of Edinburgh; Edinburgh UK
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Petersen AS, Barloese MC, Lund NL, Jensen RH. Oxygen therapy for cluster headache. A mask comparison trial. A single-blinded, placebo-controlled, crossover study. Cephalalgia 2016; 37:214-224. [PMID: 27013239 DOI: 10.1177/0333102416637817] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of this article is to investigate possible differences in effect between three types of masks in the acute treatment of cluster headache (CH). Patients and methods Fifty-seven CH patients according to ICHD-II-criteria participated in a single-blinded, semi-randomized, placebo-controlled, crossover inpatient study, and 102 CH attacks were treated with 100% oxygen delivered by demand valve oxygen (DVO), O2ptimask or simple mask (15 liters/min) or placebo delivered by DVO for 15 minutes. Primary endpoint: Two-point decrease of pain on a five-point rating scale within 15 minutes. Results Only 10 CH patients had multiple attacks and reached the point of placebo. There were no significant differences between masks in the primary endpoints ( p = 0.412). After 15 minutes 48% had a two-point decrease using the DVO compared to 45% with placebo ( p = 0.867). After 30 minutes 68% were pain free or had pain relief using DVO and 45% by placebo ( p = 0.061). The DVO was preferred by 62% compared to 5% and 33% for simple mask ( p < 0.0001) and O2ptimask ( p = 0.061). In the first attack the DVO was significantly better at achieving pain relief at 15 minutes ( p = 0.018). Treatment with DVO or O2ptimask reduced the need for rescue medication compared to the simple mask (23%, 19%, 50%, respectively). No treatment-related adverse events were observed. Conclusion The primary endpoint with pain relief at 15 minutes was non-significant; however, a post hoc analysis of the first attack significantly favored DVO. Further, therapy by O2ptimask and DVO resulted in a decreased need for rescue medication. We recommend that CH patients be offered DVO or O2ptimask before oxygen therapy is abandoned.
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Affiliation(s)
- Anja S Petersen
- Danish Headache Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Mads Cj Barloese
- Danish Headache Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Nunu Lt Lund
- Danish Headache Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Rigmor H Jensen
- Danish Headache Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
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