Optical coherence tomography (OCT) has become essential to evaluate axonal/neuronal integrity, to assess disease progression in the afferent visual pathway and to predict visual recovery after surgery in compressive optic neuropathies. Besides that OCT testing is considered a powerful biomarker of neurodegeneration and a promising outcome measure for neuroprotective trials in multiple sclerosis (MS). Currently, spectral-domain OCT (SD-OCT) technology allows quantification of retinal individual layers. The Ganglion Cell layer (GCL) investigation has become one of the most useful tools from a neuro-ophthalmic perspective. It has a high correlation with perimetry, is predictive of future progression and is a highly sensitive, specific of several neuro-ophthalmic pathologies. Moreover the superior correlation with clinical measures compared to peripapillary retinal nerve fiber layer (pRNFL) suggests that GCL analysis might be a better approach to examine MS neurodegeneration. In disorders with optic disk edema, such as ischemic optic neuropathy, papillitis and papilledema, reduction in RNFL thickness caused by axonal atrophy is difficult to distinguish from a swelling resolution. In this setting, and in buried optic nerve head drusen (ONHD), GCL analysis may provide more accurate information than RNFL analysis and it might be an early structural indicator of irreversible neuronal loss. Enhanced depth imaging OCT (EDI-OCT) provides in vivo detail of ONHD, allowing to evaluate and quantify the drusen dimensions. OCT is improving our knowledge in hereditary optic neuropathies. Furthermore, there is growing evidence about the role of OCT as an adjunctive biomarker of disorders such as Alzheimer and Parkinson's disease.
17 August 2014 in Graefe's Archive for Clinical and Experimental Ophthalmology
The effect of local and systemic injections of mesenchymal stem cells derived from adipose tissue (AD-MSC) into rabbit models of corneal allograft rejection with either normal-risk or high-risk vascularized corneal beds was investigated. The models we present in this study are more similar to human corneal transplants than previously reported murine models. Our aim was to prevent transplant rejection and increase the length of graft survival. In the normal-risk transplant model, in contrast to our expectations, the injection of AD-MSC into the graft junction during surgery resulted in the induction of increased signs of inflammation such as corneal edema with increased thickness, and a higher level of infiltration of leukocytes. This process led to a lower survival of the graft compared with the sham-treated corneal transplants. In the high-risk transplant model, in which immune ocular privilege was undermined by the induction of neovascularization prior to graft surgery, we found the use of systemic rabbit AD-MSCs prior to surgery, during surgery, and at various time points after surgery resulted in a shorter survival of the graft compared with the non-treated corneal grafts. Based on our results, local or systemic treatment with AD-MSCs to prevent corneal rejection in rabbit corneal models at normal or high risk of rejection does not increase survival but rather can increase inflammation and neovascularization and break the innate ocular immune privilege. This result can be partially explained by the immunomarkers, lack of immunosuppressive ability and immunophenotypical secretion molecules characterization of AD-MSC used in this study. Parameters including the risk of rejection, the inflammatory/vascularization environment, the cell source, the time of injection, the immunosuppression, the number of cells, and the mode of delivery must be established before translating the possible benefits of the use of MSCs in corneal transplants to clinical practice.
1 January 2019 in Alzheimer's & Dementia: Translational Research & Clinical Interventions
Introduction: The objective of this study was to investigate and compare optic nerve and retinal layers in eyes of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) with paired control eyes using optical coherence tomography. Methods: Sixty‐three eyes of 34 subjects, 12 eyes with AD and 51 eyes with MCI, positive to 11 C‐labeled Pittsburgh Compound‐B with positron emission tomography ( 11 C‐PiB PET/CT), and the same number of sex‐ and age‐paired control eyes underwent optical coherence tomography scanning analyzing retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), Bruch's membrane opening–minimum rim width (BMO‐MRW), inner plexiform layer (IPL), outer nuclear layer, and lamina cribrosa (LC). Results: Compared with healthy controls, eyes of patients with positive 11 C‐PiB PET/CT showed a significant thinning of RNFL ( P < .028) and GCL ( P < .014). IPL and outer nuclear layer also showed significant thinning in two ( P < .025) and one location ( P < .010), respectively. No significant differences were found when optic nerve measurements BMO‐MRW and LC were compared ( P > .131 and P > .721, respectively). Temporal sector GCL, average RNFL, and temporal sector RNFL also exhibited significant thinning when MCI and control eyes were compared ( P = .015, P = .005 and P = .050, respectively), and also the greatest area under the curve values (0.689, 0.647, and 0.659, respectively). GCL, IPL, and RNFL tend to be thinner in the AD group compared with healthy controls. Discussion: Our study suggests that RNFL and GCL are useful for potential screening in the early diagnosis of AD. LC and BMO‐MRW appear not to be affected by AD.
Background and objective: To investigate and compare the false-positive (FP) diagnostic classification of the Bruch’s membrane opening – minimum rim width (BMO-MRW) and retinal nerve fiber layer (RNFL) thickness in healthy eyes with tilted optic disc. Materials and methods: Fifty healthy eyes of 30 participants with tilted optic disc underwent BMO-MRW and RNFL scanning using Spectralis and macular Cirrus optical coherence tomography (OCT) scans. Results: The overall FP rate was significantly lower using BMO-MRW map compared with both RNFL map by Spectralis (8% vs 62%, respectively, P<0.001) and ganglion cell analysis (GCA) map by Cirrus (8% vs 50%, respectively, P<0.001). Specificity was significantly higher using BMO-MRW than RNFL in eyes with low (89.7% vs 41.4%, P<0.001) and moderate myopia (95.2% vs 33.3%, P<0.001). Conclusion: OCT-derived BMO-MRW analysis provides significantly greater specificity than RNFL in tilted disc irrespectively of the refractive error, and it is more specific than GCA analysis in tilted disc with moderate myopia.