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Brain, Vol. 110, No. 2, 405-414, 1987
© 1987 Oxford University Press

research-article

RETINAL VENOUS SHEATHING IN OPTIC NEURITIS

ITS SIGNIFICANCE FOR THE PATHOGENESIS OF MULTIPLE SCLEROSIS

S. LIGHTMAN1, W. I. McDONALD1,2,, A.C. BIRD1, D.A. FRANCIS2,3, A. HOSKINS1, J.R. BATCHOLER3 and A.M. HALLIDAY2

1Moorfields Eye Hospital, Institute of Neurology, Queen Square London 2Institute of Neurology, Queen Square London 3Royal Postgraduate Medical School London

Correspondence to: Correspondence to: Professor W. I. McDonald, Institute of Neurology, National Hospital, Queen Square, London WCIN 3BG.

A systematic study of the frequency of retinal vascular abnormalities and cells in the media has been made in 50 patients presenting with acute optic neuritis. Abnormalities were found in 14 (fluorescein leakage in 10, perivenous sheathing in 6, cells in the vitreous in 6 and in the anterior chamber in 4; in 2 the cells in the media were seen without vascular changes). After a mean follow up of 3.5 years multiple sclerosis (MS) had developed in 8/14 patients with vascular abnormalities and/or evidence of inflammation and in 5/32 without; the difference is significant (P < 0.02). The occurrence of perivenular abnormalities in a region free of myclin and oligodendrocytes provides evidence that the vascular changes in MS can occur independently of contiguous demyelination, and may be the primary event in the formation of a new lesion.

Received January 7, 1986. Revised April 29, 1986. Accepted June 6, 1986.


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