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Changes of retinal structure and visual function in patients with demyelinating transverse myelitis

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Abstract

Purpose

To identify the retina-structural and visual-functional alterations in the patients with aquaporin-4 (AQP4)-IgG-positive neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein-associated disease (MOGAD), and multiple sclerosis (MS) patients, all of whom had demyelinating transverse myelitis (TM) without optic neuritis (ON).

Methods

In this retrospective cross-sectional study, we reviewed the medical records of 97 patients, including 23 with AQP4-ON, 13 with AQP4-TM, 32 with MOG-ON, 3 with MOG-TM, 13 with MS-ON, and 13 with MS-TM. We measured the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell layer-inner plexiform layer (GCIPL) using optical coherence tomography to evaluate structural changes and compared these parameters with those of an age-matched healthy control. Functional outcomes were measured as visual acuity and mean deviation in visual field test.

Results

Mean RNFL and GCIPL thicknesses in all of the patients with TM were lower relative to the healthy control, while visual function was well preserved. Among the TM patients, RNFL thickness did not vary significantly among the groups, whereas GCIPL thickness in AQP4-TM and MS-TM was significantly lower than that in MOG-TM. All three TM groups showed significant mean RNFL reduction compared with the healthy control, whereas mean GCIPL thinning was evident only in AQP4-TM and MS-TM, not in MOG-TM.

Conclusion

Patients with demyelinating TM incur retina-microstructural damage that varies by specific disease entity. Damage is distinct in AQP4-IgG-positive NMOSD and MS, but it is not so severe as to cause functional damage.

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Funding

This work was supported by the New Faculty Startup Fund from Seoul National University (JHJ).

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Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jang Ho Lee, Yeji Moon, and Jong Hoon Shin. The first draft of the manuscript was written by Jang Ho Lee and Yeji Moon. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Sung-Min Kim or Jae Ho Jung.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

The study protocol was reviewed and approved by the Institutional Review Boards of Seoul National University Hospital and Pusan National University Yangsan Hospital.

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Lee, J.H., Moon, Y., Kwon, Y.N. et al. Changes of retinal structure and visual function in patients with demyelinating transverse myelitis. Neurol Sci 43, 6425–6431 (2022). https://doi.org/10.1007/s10072-022-06315-1

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  • DOI: https://doi.org/10.1007/s10072-022-06315-1

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