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Retinal Degeneration Ongoing in Pediatric MS

March 2, 2017

New research suggests that continual eye problems after demyelination isn't reserved for adults with MS only, as youth are also affected.

A prospective comparison study of more than 100 adolescents showed that those with MS had more progressive thinning of the ganglion cell–inner plexiform layer (GCIPL) of the retina than their healthy peers or those who had had a single demyelinating episode.

In addition, girls showed more pronounced retinal nerve fiber layer (RNFL) atrophy than boys, "suggesting a sexual dimorphism in the mechanisms of retinal damage and/or repair," senior author, E. Ann Yeh, MD, Hospital for Sick Children, University of Toronto, Ontario, Canada, told attendees at ACTRIMS 2017.

She added that no previous studies to date have examined these issues over time in a pediatric population. "The take-away is that kids suffer from ongoing degeneration and that, even though they may look very good, it's the beginning of a neurodegenerative process," said Dr Yeh.

"We always assumed that children were resilient and better than adults because they bounce back quickly. We've learned over the years that there is neurodegeneration, although they compensate very well," said Dr Yeh. She added that the investigators wanted to examine effects in the eye because "it really is a window to the brain in the MS population."

The researchers enrolled 106 children between 2012 and 2016. Of these, 24 were healthy (65% girls), 39 had MS (72% girls), and 43 had monophasic acquired demyelinating syndrome (monoADS; 58% girls).

The mean age at optic neuritis (ON) onset was 12.8 and 9.6 years for the latter two groups, respectively, and the mean time from incident demyelination at study entry was 2.1 and 2.4 years.

Results showed that during 1 year, GCIPL thickness decreased in the group of patients with MS, with thinning significantly more pronounced for them than for the group with monoADS.

Although RNFL thickness didn't change significantly over the study time for any of the groups, there was a significantly different trajectory between those with MS and those with monoADS, with thinning more pronounced in the former group.

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Via Medscape