TO ASSESS THE CORRELATION BETWEEN RETINAL NERVE FIBRE LAYER THICKNESS LOSS AND SEVERITY OF VISUAL IMPAIRMENT IN DIFFERENT DEMYELINATING DISEASES

Abstract

Background & Method: Study conducted on 30 patients who attended the OPD of upgraded department of Ophthalmology. 60 eyes of 30 different patients of diagnosed cases of multiple sclerosis, neuromyelitis optical, and clinically isolated syndrome who had an H/O attack of Optic neuritis were selected.

Result: Severity of RNFL thickness loss in affected eyes of NMO (45.5µm; 83.34%) is more than MS (66.15µm; 65%). In CIS, RNFL thickness is highest (111.5µm). RNFL thickness loss is more in fellow eyes of MS (56.25%)than NMO. CIS shows normal RNFL thickness. Coefficient of Correlation by Spearman’s Rho (R)-0.942, two tailed P value is 0.0048.by normal standards there is strong correlation between RNFL thickness loss with severity of visual impairment in affected eyes and it is statistically significant in affected eyes.

Conclusion: Severity of RNFL thickness loss is associated with the severity of visual impairment. Hence can predict the progression of visual impairment in demyelinating diseases. Visual prognosis is much worse if optic neuritis occurs in patients with neuromyelitis optica, which leads to a more sever thinning of the RNFL when compared to optic neuritis in multiple sclerosis patients. This suggests that NMO is associated with more widespread axonal injury in the affected optic nerves. OCT can help distinguish the etiology of these two causes of ON, and may be useful as a surrogate marker of axonal involvement in demyelinating diseases.

Keywords: Retinal, impairment, demyelinating & nerve.