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Reduced retinal nerve fiber layer (RNFL) thickness in ALS patients: a window to disease progression

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Abstract

Objectives

To assess RNFL thickness in ALS patients and compare it to healthy controls, and to detect possible correlations between RNFL thickness in ALS patients and disease severity and duration.

Methods

Study population consisted of ALS patients and age- and sex-matched controls. We used the revised ALS functional rating scale (ALSFRS-R) as a measure of disease severity. RNFL thickness in the four quadrants were measured with a spectral domain OCT (Topcon 3D, 2015).

Results

We evaluated 20 ALS patients (40 eyes) and 25 healthy matched controls. Average RNFL thickness in ALS patients was significantly reduced compared to controls (102.57 ± 13.46 compared to 97.11 ± 10.76, p 0.04). There was a significant positive correlation between the functional abilities of the patients based on the ALSFRS-R and average RNFL thickness and also RNFL thickness in most quadrants. A linear regression analysis proved that this correlation was independent of age. In ALS patients, RNFL thickness in the nasal quadrant of the left eyes was significantly reduced compared to the corresponding quadrant in the right eyes even after adjustment for multiplicity (85.80 ± 23.20 compared to 96.80 ± 16.96, p = 0.008).

Conclusion

RNFL thickness in ALS patients is reduced compared to healthy controls. OCT probably could serve as a marker of neurodegeneration and progression of the disease in ALS patients. RNFL thickness is different among the right and left eyes of ALS patients pointing to the fact that asymmetric CNS involvement in ALS is not confined to the motor system.

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Author information

Authors and Affiliations

  1. Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Vali-e-Asr Sq., Beh-Afarin Blvd, Tehran, 1417613151, Iran

    Fahimeh Haji Akhoundi

  2. Department of Community and Preventive Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Alipasha Meysamie

  3. Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran

    Babak Zamani

  4. Firoozgar Research Center, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Mahdi Sowlat

  5. Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Rohani

  6. Division of Neurology, Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson’s Disease, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada

    Mohammad Rohani

Authors
  1. Mohammad Rohani
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  2. Alipasha Meysamie
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  3. Babak Zamani
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  4. Mohammad Mahdi Sowlat
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  5. Fahimeh Haji Akhoundi
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Contributions

FHA: study concept and design, acquisition of data, preparing the manuscript. AM: analysis and interpretation of data. BZ: acquisition of data, study supervision. MMS: acquisition of data. MR: study concept and design, critical revision of manuscript for intellectual content, study supervision.

Corresponding author

Correspondence to Fahimeh Haji Akhoundi.

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Conflicts of interest

The authors report no conflicts of interest.

Ethical standard

The study was approved by the institutional ethics committee (Medical school ethics committee, Iran University of Medical Sciences).

Informed consent

Informed consents were signed by all patients.

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Rohani, M., Meysamie, A., Zamani, B. et al. Reduced retinal nerve fiber layer (RNFL) thickness in ALS patients: a window to disease progression. J Neurol 265, 1557–1562 (2018). https://doi.org/10.1007/s00415-018-8863-2

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  • DOI: https://doi.org/10.1007/s00415-018-8863-2

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