Progressive changes in the retinal nerve fiber layer in patients with multiple sclerosis

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Optic nerve involvement is common in MS, potentially leading to vision loss.
• Quantifying axonal loss is crucial for understanding disease progression.

Purpose of the Study:

• To quantify 1-year changes in retinal nerve fiber layer (RNFL) thickness in MS patients.
• To compare noninvasive imaging (OCT, GDx) and visual evoked potentials (VEP) in detecting axonal loss.

Main Methods:

• Eighty-one MS patients underwent comprehensive ophthalmic exams, including OCT, GDx, and VEP.
• Re-evaluation after 12 months allowed for change quantification.
• One eye per patient was analyzed.

Main Results:

• Significant RNFL thickness and macular volume changes detected by OCT.
• Significant changes in RNFL standard deviation detected by GDx.
• Structural measurements (OCT, GDx) detected optic nerve changes, unlike functional VEP assessments.

Conclusions:

• MS patients exhibit greater axonal loss than healthy individuals.
• This loss occurs irrespective of prior optic neuritis history.
• Structural imaging is more sensitive than VEP for detecting axonal loss in MS.