Detection of clinical and subclinical retinal abnormalities in neurosarcoidosis with optical coherence tomography
Identifieur interne : 001566 ( Main/Exploration ); précédent : 001565; suivant : 001567Detection of clinical and subclinical retinal abnormalities in neurosarcoidosis with optical coherence tomography
Auteurs : Christopher Eckstein [États-Unis] ; Shiv Saidha [États-Unis] ; Elias S. Sotirchos [États-Unis] ; Gita Byraiah [États-Unis] ; Michaela Seigo [États-Unis] ; Aleksandra Stankiewicz [États-Unis] ; Stephanie B. Syc [États-Unis] ; E Ona Ford [États-Unis] ; Srilakshmi Sharma [États-Unis] ; Peter A. Calabresi [États-Unis] ; Carlos A. Pardo [États-Unis]Source :
- Journal of Neurology [ 0340-5354 ] ; 2012-07-01.
English descriptors
Abstract
Abstract: The aim of this work was to determine if neurosarcoidosis (NS) patients exhibit quantitative and/or qualitative in vivo evidence of retinal abnormalities on optical coherence tomography (OCT). Retinal imaging was performed using spectral-domain Cirrus HD-OCT in 20 NS patients (40 eyes) and 24 age-matched healthy controls (48 eyes). Study participants also underwent magnetic resonance imaging of the brain and spine, cerebrospinal fluid (CSF) analysis, and detailed neurological and ophthalmological evaluation. Quantitative OCT abnormalities of average macular thickness (AMT), peri-papillary retinal nerve fiber layer (RNFL) thickness, or both, were detectable in 60% of NS patients. Of NS patients with ocular symptomatology, 75% demonstrated quantitative OCT abnormalities, while only 25% had detectable abnormalities on detailed ophthalmological assessment. Furthermore, 33% of NS patients without ocular symptoms had quantitative OCT changes, while only 8% had abnormal ophthalmologic examination. RNFL and macular thinning and swelling were significant in the NS cohort compared to healthy controls (variance ratio testing; RNFL: p = 0.02, AMT: p = 0.006). AMT also correlated inversely with disease duration (r s = −0.65, p = 0.002). Patient proportions with OCT abnormalities did not differ according to NS subtype (myelopathic, meningeal, or encephalitic NS), CSF findings, or immunotherapy exposure. No qualitative OCT abnormalities were detected. Retinal abnormalities occur in all NS subtypes, and may be clinical or subclinical. Our findings suggest OCT may enable greater detection of retinal abnormalities in NS than ophthalmological assessment alone, and have implications for the assessment of ocular involvement in NS, and sarcoidosis in general. Longitudinal NS studies utilizing OCT are warranted.
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DOI: 10.1007/s00415-011-6363-8
Affiliations:
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Wolfe Street, Pathology 627, 21287, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology</title><title level="j" type="sub">Official Journal of the European Neurological Society</title><title level="j" type="abbrev">J Neurol</title><idno type="ISSN">0340-5354</idno><idno type="eISSN">1432-1459</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2012-07-01">2012-07-01</date><biblScope unit="volume">259</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="1390">1390</biblScope><biblScope unit="page" to="1398">1398</biblScope></imprint><idno type="ISSN">0340-5354</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0340-5354</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Neurosarcoidosis</term><term>Optic neuropathy</term><term>Optical coherence tomography</term><term>Retina</term><term>Uveitis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: The aim of this work was to determine if neurosarcoidosis (NS) patients exhibit quantitative and/or qualitative in vivo evidence of retinal abnormalities on optical coherence tomography (OCT). Retinal imaging was performed using spectral-domain Cirrus HD-OCT in 20 NS patients (40 eyes) and 24 age-matched healthy controls (48 eyes). Study participants also underwent magnetic resonance imaging of the brain and spine, cerebrospinal fluid (CSF) analysis, and detailed neurological and ophthalmological evaluation. Quantitative OCT abnormalities of average macular thickness (AMT), peri-papillary retinal nerve fiber layer (RNFL) thickness, or both, were detectable in 60% of NS patients. Of NS patients with ocular symptomatology, 75% demonstrated quantitative OCT abnormalities, while only 25% had detectable abnormalities on detailed ophthalmological assessment. Furthermore, 33% of NS patients without ocular symptoms had quantitative OCT changes, while only 8% had abnormal ophthalmologic examination. RNFL and macular thinning and swelling were significant in the NS cohort compared to healthy controls (variance ratio testing; RNFL: p = 0.02, AMT: p = 0.006). AMT also correlated inversely with disease duration (r s = −0.65, p = 0.002). Patient proportions with OCT abnormalities did not differ according to NS subtype (myelopathic, meningeal, or encephalitic NS), CSF findings, or immunotherapy exposure. No qualitative OCT abnormalities were detected. Retinal abnormalities occur in all NS subtypes, and may be clinical or subclinical. Our findings suggest OCT may enable greater detection of retinal abnormalities in NS than ophthalmological assessment alone, and have implications for the assessment of ocular involvement in NS, and sarcoidosis in general. Longitudinal NS studies utilizing OCT are warranted.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Eckstein, Christopher" sort="Eckstein, Christopher" uniqKey="Eckstein C" first="Christopher" last="Eckstein">Christopher Eckstein</name></region><name sortKey="Byraiah, Gita" sort="Byraiah, Gita" uniqKey="Byraiah G" first="Gita" last="Byraiah">Gita Byraiah</name><name sortKey="Calabresi, Peter A" sort="Calabresi, Peter A" uniqKey="Calabresi P" first="Peter A." last="Calabresi">Peter A. Calabresi</name><name sortKey="Eckstein, Christopher" sort="Eckstein, Christopher" uniqKey="Eckstein C" first="Christopher" last="Eckstein">Christopher Eckstein</name><name sortKey="Ford, E Ona" sort="Ford, E Ona" uniqKey="Ford E" first="E Ona" last="Ford">E Ona Ford</name><name sortKey="Pardo, Carlos A" sort="Pardo, Carlos A" uniqKey="Pardo C" first="Carlos A." last="Pardo">Carlos A. Pardo</name><name sortKey="Saidha, Shiv" sort="Saidha, Shiv" uniqKey="Saidha S" first="Shiv" last="Saidha">Shiv Saidha</name><name sortKey="Seigo, Michaela" sort="Seigo, Michaela" uniqKey="Seigo M" first="Michaela" last="Seigo">Michaela Seigo</name><name sortKey="Sharma, Srilakshmi" sort="Sharma, Srilakshmi" uniqKey="Sharma S" first="Srilakshmi" last="Sharma">Srilakshmi Sharma</name><name sortKey="Sotirchos, Elias S" sort="Sotirchos, Elias S" uniqKey="Sotirchos E" first="Elias S." last="Sotirchos">Elias S. Sotirchos</name><name sortKey="Stankiewicz, Aleksandra" sort="Stankiewicz, Aleksandra" uniqKey="Stankiewicz A" first="Aleksandra" last="Stankiewicz">Aleksandra Stankiewicz</name><name sortKey="Syc, Stephanie B" sort="Syc, Stephanie B" uniqKey="Syc S" first="Stephanie B." last="Syc">Stephanie B. Syc</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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