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November 2008

The Retina as a Window to the Brain—Reply

Arch Neurol. 2008;65(11):1548. doi:10.1001/archneur.65.11.1548-a

In reply

We would like to thank Dhillon and Dhillon for their interest in our recent article. We certainly agree with their observation that our findings of subtle vascular abnormalities in MS lesions detected at 7-T MRI “may have relevance to microvascular signs observed in the retina” because neurovascular abnormalities may provide insights into the pathogenesis of MS.

Although retinal vasculitis has been found in 9% to 23% of patients with MS,1 most of the studies on retinal vascular abnormalities associated with MS were performed using fundus photography or fluorescein angiography. As Dhillon and Dhillon pointed out, the retina and brain may have a shared pathogenesis of MS. It has been reported that retinal venous sheathing is seen in patients with MS,2 and these perivenular abnormalities in a region free of myelin indicate that vascular changes may be a primary event of lesion formation in MS.3

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