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Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

1
IRCCS—Fondazione Bietti, Via Livenza 1, 00198 Rome, Italy
2
Unit of Neurology, Fondazione Policlinico Tor Vergata, Via Oxford 81, 00133 Rome, Italy
3
Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy
4
Department of Ophthalmology, University of Warmia and Mazury, Michała Oczapowskiego 2, 10455 Olsztyn, Poland
5
Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Collegium Maius Fredry 10, 61701 Poznań, Poland
6
Ophthalmology Department, IRCCS—Fondazione Policlinico Universitario A. Gemelli, Catholic University, Largo F. Vito 1, 00168 Rome, Italy
7
Unit of Neurology and Neurorehabilitation, IRCCS—Neuromed, Via Atinense 18, 86077 Pozzilli (IS), Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(11), 3766; https://doi.org/10.3390/jcm9113766
Received: 26 October 2020 / Revised: 11 November 2020 / Accepted: 20 November 2020 / Published: 22 November 2020
(This article belongs to the Section Ophthalmology)
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 (p < 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. View Full-Text
Keywords: multiple sclerosis; preganglionic retinal elements; photoreceptors; bipolar cells; multifocal electroretinogram; neurodegeneration multiple sclerosis; preganglionic retinal elements; photoreceptors; bipolar cells; multifocal electroretinogram; neurodegeneration
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MDPI and ACS Style

Ziccardi, L.; Barbano, L.; Boffa, L.; Albanese, M.; Nicoletti, C.G.; Landi, D.; Grzybowski, A.; Falsini, B.; Marfia, G.A.; Centonze, D.; Parisi, V. Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis. J. Clin. Med. 2020, 9, 3766. https://doi.org/10.3390/jcm9113766

AMA Style

Ziccardi L, Barbano L, Boffa L, Albanese M, Nicoletti CG, Landi D, Grzybowski A, Falsini B, Marfia GA, Centonze D, Parisi V. Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis. Journal of Clinical Medicine. 2020; 9(11):3766. https://doi.org/10.3390/jcm9113766

Chicago/Turabian Style

Ziccardi, Lucia, Lucilla Barbano, Laura Boffa, Maria Albanese, Carolina G. Nicoletti, Doriana Landi, Andrzej Grzybowski, Benedetto Falsini, Girolama A. Marfia, Diego Centonze, and Vincenzo Parisi. 2020. "Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis" Journal of Clinical Medicine 9, no. 11: 3766. https://doi.org/10.3390/jcm9113766

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