OCT: Hot Topics in Neurology
Seong-Hae Jeong
Department of Neurology, Chungnam National University Hospital
Optical Coherence Tomography
;Hot topics in neurology
Seong-Hae Jeong Department of Neurology Chungnam National University Hospital
Nat.Rev.Neurol, 2013
The eye as an extension of the CNS Ocular manifestations of neurological disease
Neurology, 2015
OCT features in select neurologic diseases
Neurology, 2015
Why useful?
• Diagnosis
• Monitor disease progression or treatment side effects
• Prognostic value in wide range of neuro- ophthalmological disease
Retinal layer segmentation
Nature review 2007
Mult Scler. 2014
Contents
• Demyelinating disease
• Degenerative disease
• Miscellaneous
Contents
• Demyelinating disease – Multiple sclerosis
– Neuromyelitis optica spectrum disorders
• Degenerative disease
• Miscellaneous
Lancet Neurol 2017
Retinal parameters acquired by OCT
Multiple sclerosis, 2015
Typical differences in retinal damage between NMO-ON and MS-ON
Multiple sclerosis, 2015
Multiple sclerosis, 2015
Summary of neuro-ophthalmological parameters in NMO compared to MS
Contents
• Demyelinating disease
• Degenerative disease – Alzheimer disease – Parkinson disease
– Multiple systemic atrophy
• Miscellaneous
Alzheimer disease
• Decreased RNFL thickness
• Increased optic disc cupping
• Vascular tortuosity
• Vision impairment
• Abnormalities on electroretinogram
• Normal visual acuity, normal visual fields, and normal color vision
• Decreased choroidal thickness
• OCT may play a role in early detection of AD but more studies are required to validate its utility as a
biomarker of disease
Parkinson disease
PLoS ONE 2014
Parkinson disease
• inner retinal layers (IRL 5 RNFL 1 GCL 1 IPL) thinning in patients with PD and decreased contrast sensitivity compared to healthy controls.
• GCL thickness was inversely correlated with disease duration and severity.
• patients with PD early in the disease or in those patients who present with a paucity of
symptoms or atypical clinical manifestations.
Front Neurol 2017
Summary of retinal OCT studies in MSA
Retinal abnormalities in MSA
Front Neurol 2017
Contents
• Demyelinating disease
• Degenerative disease
• Miscellaneous
Toxic/metabolic/drug-induced optic neuropathy
• Ethambutol
• Vitamin B 12 deficiency
Drug-induced retinopathy
• Vigabatrin
• Fingolimod
Migraine
• RNFL measurements have been shown to be thinner in migraineurs compared to controls.
• Measurements of choroidal thickness were found to be increased during an acute attack in migraine patients when compared to baseline level in the same patient and when compared to a control group.
• Further studies are needed to determine the significance and clinical utility of these findings.
