Using a very cool technology called optical coherence tomography (OCT) a new study has demonstrated progressive thinning of the retinal nerve fibre layer as a function of time in some patients with MS. Importantly, this thinning occurred in either the presence or absence of previous optic neuritis (focal inflammation in the optic nerve) and was associated with clinically significant visual loss.
These findings indicate that asymptomatic or sub-clinical nerve fibre (or axonal loss) occurs in the visual pathways in MS.
1. If these findings can be confirmed it will add credence to the claims that MS is a primary neurodegenerative disease. “I hope not.”
2. This study supports the use of OCT as a method to evaluate the effectiveness of neuroprotective agents in MS; we will need to show that drugs or combinations of drugs stop or at least slow down this loss of nerve fibres to accept that they are “neuroprotective”.
Click here: Talman et al. Longitudinal study of vision and retinal nerve fiber layer thickness in MS. Ann Neurol 2010; in press.