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August 2010

Evaluating Retinal Abnormalities in Patients With Multiple Sclerosis—Reply

Author Affiliations

Author Affiliations: Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia (Drs Balcer and Galetta); Department of Neurology, University of Texas Southwestern Medical Center at Dallas (Dr Frohman); and the Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Calabresi).

Arch Neurol. 2010;67(8):1035-1036. doi:10.1001/archneurol.2010.181

In reply

We thank Khanifar and colleagues for their letter regarding our article.1 Their comments are very timely and much appreciated given the recent emergence of high-resolution SD-OCT technologies, particularly for measuring the retinal ganglion cell layer.2,3 It is exciting and important that our ongoing investigations of visual function and OCT in MS now incorporate SD-OCT and will benefit from use of these new methods with respect to (1) greater resolution of images (10 μm vs 5 μm axial resolution, as pointed out by Khanifar and colleagues); (2) higher degrees of interrater and test-retest reliability of measurements in the eyes of persons with MS, as shown by 2 recent studies by our collaborative group4,5; and (3) reduced operator dependency of scan placement. Unlike TD-OCT, for which a single brand is available (OCT-3/Stratus OCT), there are already several manufacturers of SD-OCT. Several MS clinical trials have incorporated TD-OCT measures of retinal nerve fiber layer thickness and macular thickness and volume as exploratory outcomes; these trials will require continued evaluation of TD-OCT measurements, while careful consideration of differences between high-resolution and current technologies and their costs will have to be weighed for future MS trials.

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