December 26, 2012
Eye Scans Help Doctors Tell How Fast Multiple Sclerosis Progression Occurs
Lawrence LeBlond for redOrbit.com - Your Universe Online
Patients with debilitating multiple sclerosis may discover just how fast their nervous system disease is progressing with a new quick and easy test. The test, known as an Optical Coherence Tomography (OCT) scan, takes just a few minutes per eye and can be performed at a general practitioner´s surgery.The finding comes from a test of 164 MS patients measuring the thickness of the lining at the back of the eye. The test was performed every six months for an average of 21 months. Researchers from Johns Hopkins University found that patients with thinning of the retina had both earlier and more active forms of the disease.
Reporting the findings in the journal Neurology, the researchers said the findings are only preliminary and a much larger trial would be needed with longer follow ups to judge how useful the eye scan might be in an everyday practice.
In patients with MS, the nerves in the brain and spinal cord are affected causing serious problems with muscle movement, balance and vision. Protective layers (myelin) around these affected nerves are attacked, leaving the nerves open to damage.
About 8 out of 10 of people have a type of MS known as relapsing remitting, which means people will have periods where symptoms are mild or non-existent followed by periods of flare-ups. But after about ten years, around half of these people will develop a secondary progressive form of the disease where symptoms get worse and remissions are fewer.
It is extremely difficult for doctors to monitor MS because of the unpredictable nature of the disease. Scientists are hoping OCT scans can provide a good way around that difficulty. There is no cure for MS but treatments can help slow progression of the disease.
In the study, the team found that patients with MS relapses had 42 percent faster retinal thinning than those with no relapses. Patients with inflammatory lesions called gadolinium-enhancing lesions had 54 percent faster retinal thinning, and those with new T2 lesions had 36 percent faster thinning, compared to those who did not have evidence of such lesions on their MRIs.
The study team also found that patients whose disability levels worsened during the study period had 37 percent more retinal thinning than those who had no changes in their disability levels. And patients who had MS for less than 5 years had 43 percent faster retinal thinning than those who had the disease longer than 5 years.
The findings suggest that retinal thinning occurs faster in patients with earlier and more active MS, than in those who have had the disease longer.
“As more therapies are developed to slow the progression of MS, testing retinal thinning in the eyes may be helpful in evaluating how effective those therapies are,” study author Dr. Peter Calabresi, told the BBC.
“This study reports an important link between the inflammatory and neurodegenerative aspects of MS that should lead to a better understanding of the underlying mechanisms of tissue damage,” said Dr. Fred Lublin, director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at the Icahn School of Medicine at Mount Sinai, NYC.
Lublin, who was not involved in the study, told US Health News: “The techniques described may add to our ability to better perform studies of neuroprotective agents in MS.”
This study was supported by the National Multiple Sclerosis Society, the National Eye Institute and Braxton Debbie Angela Dillon and Skip Donor Advisor Fund.