Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning.

Area of Science:

• Neuroscience
• Ophthalmology
• Radiology

Background:

• Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS).
• Retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform (GCIP) layer thinning are observed in MS patients.
• The relationship between clinical/radiologic disease activity and retinal layer thinning in MS requires further elucidation.

Purpose of the Study:

• To investigate the impact of clinical and radiologic disease activity on the rate of GCIP layer thinning in MS patients.
• To assess whether retinal changes correlate with global CNS processes in MS.
• To evaluate the potential of optical coherence tomography (OCT)-derived GCIP thickness as an outcome measure for neuroprotective therapies in MS.

Main Methods:

• 164 MS patients and 59 healthy controls underwent spectral-domain OCT scans every 6 months for a mean follow-up of 21.1 months.
• Baseline and annual contrast-enhanced brain MRIs were performed to assess disease activity.
• Patients who developed optic neuritis were excluded to isolate non-ocular disease effects.

Main Results:

• Patients with relapses, new gadolinium-enhancing lesions, or new T2 lesions showed significantly faster annualized GCIP thinning.
• Disability progression and shorter disease duration (<5 years) were associated with accelerated GCIP thinning.
• The combination of new MRI lesions and early disease duration (<5 years) resulted in the most rapid GCIP thinning.

Conclusions:

• Clinical and radiologic disease activity, particularly in early MS, accelerates GCIP thinning.
• Retinal thinning in MS appears to reflect broader CNS inflammatory and degenerative processes.
• OCT-derived GCIP thickness is a promising biomarker for assessing treatment efficacy, especially in early, active MS.