Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neuropsychiatry

the distinction between multiple sclerosis (MS) and neuromyelitis optica (NMO) is sometimes challenging on clinical bases. Objective: evaluation of the potential usefulness of OCT in discriminating MS related ON from that related to NMO through assessment of retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thicknesses. Design/Methods: this was a cross-sectional study which included 30 MS and 15 NMO patients with history of ON who were compared to 15 healthy controls. All participants were subjected to full neurological examination, ophthalmological assessment and OCT. Results: there was a significant thinning of RNFL in NMO-ON (67.569 æm ±18.52) and MS-ON (88.982 æm ±29.2) patients than healthy controls (109.729æm±31.38). The cut-off value of RNFL thickness for discrimination between MS related ON and NMO related ON was 81.65 æm with 85.19% sensitivity and 72.09% specificity, while the cut-off value of GCL thickness was 74.21æm with 77.78% sensitivity and 79.07% specificity. Temporal / superior (T/S) ratio was significantly different between MS-ON and NMO-ON. The estimated cut-off was 0.68 with 32.56% sensitivity and 100% specificity. Both groups of patients showed a significant positive correlation between visual acuity (VA) and RNFL thickness. However, only the group of MS-ON patients showed a significant negative correlation with Extended disability status scale (EDSS) score (p value < 0.05)

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