Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis
The involvement of macular preganglionic elements’ function, during the neurodegenerative process of multiple sclerosis (MS), is controversial. In this case-control observational and retrospective study, we assessed multifocal electroretinogram (mfERG) responses from 41 healthy Controls, 41 relapsin...
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doaj-23dfd96933544c28829d7410e95dc8282020-11-25T04:09:53ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-0193766376610.3390/jcm9113766Functional Assessment of Outer and Middle Macular Layers in Multiple SclerosisLucia Ziccardi0Lucilla Barbano1Laura Boffa2Maria Albanese3Carolina Gabri Nicoletti4Doriana Landi5Andrzej Grzybowski6Benedetto Falsini7Girolama Alessandra Marfia8Diego Centonze9Vincenzo Parisi10IRCCS—Fondazione Bietti, Via Livenza 1, 00198 Rome, ItalyIRCCS—Fondazione Bietti, Via Livenza 1, 00198 Rome, ItalyUnit of Neurology, Fondazione Policlinico Tor Vergata, Via Oxford 81, 00133 Rome, ItalyUnit of Neurology, Fondazione Policlinico Tor Vergata, Via Oxford 81, 00133 Rome, ItalyMultiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, ItalyMultiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, ItalyDepartment of Ophthalmology, University of Warmia and Mazury, Michała Oczapowskiego 2, 10455 Olsztyn, PolandOphthalmology Department, IRCCS—Fondazione Policlinico Universitario A. Gemelli, Catholic University, Largo F. Vito 1, 00168 Rome, ItalyMultiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, ItalyMultiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, ItalyIRCCS—Fondazione Bietti, Via Livenza 1, 00198 Rome, ItalyThe involvement of macular preganglionic elements’ function, during the neurodegenerative process of multiple sclerosis (MS), is controversial. In this case-control observational and retrospective study, we assessed multifocal electroretinogram (mfERG) responses from 41 healthy Controls, 41 relapsing-remitting MS patients without optic neuritis (ON) (MS-noON Group) and 47 MS patients with ON: 27 with full recovery of high-contrast best corrected visual acuity (BCVA) (MS-ON-G Group) and 20 with poor recovery (between 0.2 and 1 LogMAR) of BCVA, (MS-ON-P Group). In the latter Group, Sd-OCT macular volumes and thicknesses of whole and inner and outer retina were measured. MfERG N1 and P1 implicit times (ITs), and N1-P1 response amplitude densities (RADs), were measured from concentric rings (R) with increasing foveal eccentricity: 0–5° (R1), 5–10° (R2), 10–15° (R3), 15–20° (R4), 20–25° (R5), and from retinal sectors (superior, nasal, inferior and temporal) between 0–15° and 0–25°. In the MS-ON-P Group, mean mfERG RADs detected from R1 (0–5°) and from the central nasal sector (0–15°) were significantly reduced (<i>p</i> < 0.01) with respect to those of the Control, MS-noON and MS-ON-G Groups. No other significant differences between Groups for any mfERG parameters were found. All Sd-OCT measurements, apart from the inner retina macular volume in the central 1 mm, were significantly reduced in MS-ON-P patients compared to Controls. The functional impairment in the MS-ON-P Group was associated but not correlated with structural changes of the outer and inner retinal layers in corresponding retinal Areas and Sectors. Our results suggest that in MS, exclusively after ON with poor recovery of BCVA, the neurodegenerative process can induce dysfunctional mechanisms involving photoreceptors and bipolar cells of the fovea and of the more central nasal macular area.https://www.mdpi.com/2077-0383/9/11/3766multiple sclerosispreganglionic retinal elementsphotoreceptorsbipolar cellsmultifocal electroretinogramneurodegeneration |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lucia Ziccardi Lucilla Barbano Laura Boffa Maria Albanese Carolina Gabri Nicoletti Doriana Landi Andrzej Grzybowski Benedetto Falsini Girolama Alessandra Marfia Diego Centonze Vincenzo Parisi |
spellingShingle |
Lucia Ziccardi Lucilla Barbano Laura Boffa Maria Albanese Carolina Gabri Nicoletti Doriana Landi Andrzej Grzybowski Benedetto Falsini Girolama Alessandra Marfia Diego Centonze Vincenzo Parisi Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis Journal of Clinical Medicine multiple sclerosis preganglionic retinal elements photoreceptors bipolar cells multifocal electroretinogram neurodegeneration |
author_facet |
Lucia Ziccardi Lucilla Barbano Laura Boffa Maria Albanese Carolina Gabri Nicoletti Doriana Landi Andrzej Grzybowski Benedetto Falsini Girolama Alessandra Marfia Diego Centonze Vincenzo Parisi |
author_sort |
Lucia Ziccardi |
title |
Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis |
title_short |
Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis |
title_full |
Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis |
title_fullStr |
Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis |
title_full_unstemmed |
Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis |
title_sort |
functional assessment of outer and middle macular layers in multiple sclerosis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-11-01 |
description |
The involvement of macular preganglionic elements’ function, during the neurodegenerative process of multiple sclerosis (MS), is controversial. In this case-control observational and retrospective study, we assessed multifocal electroretinogram (mfERG) responses from 41 healthy Controls, 41 relapsing-remitting MS patients without optic neuritis (ON) (MS-noON Group) and 47 MS patients with ON: 27 with full recovery of high-contrast best corrected visual acuity (BCVA) (MS-ON-G Group) and 20 with poor recovery (between 0.2 and 1 LogMAR) of BCVA, (MS-ON-P Group). In the latter Group, Sd-OCT macular volumes and thicknesses of whole and inner and outer retina were measured. MfERG N1 and P1 implicit times (ITs), and N1-P1 response amplitude densities (RADs), were measured from concentric rings (R) with increasing foveal eccentricity: 0–5° (R1), 5–10° (R2), 10–15° (R3), 15–20° (R4), 20–25° (R5), and from retinal sectors (superior, nasal, inferior and temporal) between 0–15° and 0–25°. In the MS-ON-P Group, mean mfERG RADs detected from R1 (0–5°) and from the central nasal sector (0–15°) were significantly reduced (<i>p</i> < 0.01) with respect to those of the Control, MS-noON and MS-ON-G Groups. No other significant differences between Groups for any mfERG parameters were found. All Sd-OCT measurements, apart from the inner retina macular volume in the central 1 mm, were significantly reduced in MS-ON-P patients compared to Controls. The functional impairment in the MS-ON-P Group was associated but not correlated with structural changes of the outer and inner retinal layers in corresponding retinal Areas and Sectors. Our results suggest that in MS, exclusively after ON with poor recovery of BCVA, the neurodegenerative process can induce dysfunctional mechanisms involving photoreceptors and bipolar cells of the fovea and of the more central nasal macular area. |
topic |
multiple sclerosis preganglionic retinal elements photoreceptors bipolar cells multifocal electroretinogram neurodegeneration |
url |
https://www.mdpi.com/2077-0383/9/11/3766 |
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