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The Retinal Nerve Fiber Layer of Patients With Neuromyelitis Optica and Chronic Relapsing Optic Neuritis is More Severely Damaged than Patients With Multiple Sclerosis

Bichuetti, Denis B. MD, PhD; de Camargo, André S. MD; Falcão, Alessandra B. MD; Gonçalves, Fabiana F. MD; Tavares, Ivan M. MD, PhD; de Oliveira, Enedina M.L. MD, PhD

doi: 10.1097/WNO.0b013e31829f39f1
Original Contribution
Japanese Abstract

Backgroud: To compare the retinal nerve fiber layer (RNFL) in eyes of patients with relapsing remitting multiple sclerosis (RRMS), neuromyelitis optica (NMO) and chronic relapsing inflammatory optic neuritis (CRION).

Methods: Evaluation of 62 patients with RRMS, NMO, and CRION in a cross-sectional study with spectral domain optical coherence tomography.

Results: A total of 124 eyes were evaluated (96 RRMS, 18 NMO, and 10 CRION). Frequency of optic neuritis for each disease was: 34% for RRMS, 84% for NMO, and 100% for CRION. Visual acuity and RNFL thickness were significantly worse in NMO and CRION eyes than in RRMS, but there were no differences between NMO and CRION eyes. A RNFL of 41 μm was 100% specific for optic neuritis associated with NMO and CRION when compared to RRMS.

Conclusion: This study established RNFL values to differentiate optic neuritis of RRMS from NMO and CRION. Although similarities observed between NMO and CRION eyes might suggest that they are within the same disease spectrum, it is still recommended that these 2 conditions be differentiated on clinical grounds. Optical coherence tomography serves as an additional diagnostic tool and can be used to monitor disease progression.

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Departamento de Neurologia e Neurocirurgia (DBB, ABF, EMLdO) and Departamento de Oftalmologia (ASdC, FFG, IMT), Universidade Federal de São Paulo, São Paulo, Brazil.

Address correspondence to Denis B. Bichuetti, MD, PhD, Disciplina de Neurologia, Universidade Federal de São Paulo, (Neurology Discipline, Federal University of São Paulo), Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil; E-mail:

D.B. Bichuetti has received speaking honoraria from Bayer Health Care, TEVA, and Merck Serono and travel expenses to scientific meetings from Bayer Health Care, Merck Serono, Novartis, and Teva. E.M.L. de Oliveira received compensations for participating in meetings sponsored by Bayer Health Care, Biogen Idec, Merck Serono, Novartis, and Teva. A.B. Falcão received travel expenses to scientific meetings from Bayer Health Care, Merck Serono, and Novartis. I.M. Tavares has received travel expenses to scientific meetings from Alcon, Allergan, and Merck Sharp & Dohme and is a medical advisor at Allergan and Merck Sharp & Dohme. A.S. de Camargo reports no conflicts of interest.

Denis B. Bichuetti had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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© 2013 by North American Neuro-Ophthalmology Society