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Retinal periphlebitis is associated with multiple sclerosis severity

Santiago Ortiz-Pérez1, Elena H Martínez-Lapiscina, Iñigo Gabilondo

  • 1Center of Neuroimmunology, Department of Neurology, Institute of Biomedical Research August Pi Sunyer, Hospital Clinic of Barcelona, Spain.

Neurology
|August 2, 2013
PubMed
Abstract

Insights

Retinal periphlebitis (RP) is linked to increased multiple sclerosis (MS) severity. Patients with RP showed greater disability, higher brain lesion volume, and reduced retinal nerve fiber layer thickness, supporting RP as an MS severity biomarker.

Area of Science:

  • Neuroimmunology
  • Ophthalmology
  • Radiology

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
  • Assessing MS severity relies on clinical, imaging, and functional biomarkers.
  • Primary retinal inflammation, such as retinal periphlebitis (RP), may offer insights into MS pathology.

Purpose of the Study:

  • To investigate the association between primary retinal inflammation (retinal periphlebitis and microcystic macular edema) and biomarkers of multiple sclerosis severity.
  • To correlate retinal findings with clinical disability, brain MRI metrics, and retinal structural changes.

Main Methods:

  • A cohort of 100 MS patients underwent comprehensive ophthalmic and neurologic examinations, MRI, and optical coherence tomography.
  • Disability was measured using the Expanded Disability Status Scale (EDSS) at baseline and 1-year follow-up.
  • Brain imaging assessed normalized brain volume, gray matter volume, and T1 lesion volume; retinal imaging measured nerve fiber layer thickness and macular volume.

Main Results:

  • Five patients exhibited RP, two had microcystic macular edema, and 93 had normal retinas.
  • Patients with RP showed a trend towards higher baseline EDSS scores and disability progression.
  • RP was associated with significantly higher T1 lesion volume (p=0.038) and lower retinal nerve fiber layer thickness (p=0.018).

Conclusions:

  • Retinal periphlebitis (RP) is a potential biomarker for multiple sclerosis severity.
  • RP is associated with increased disability, greater brain lesion burden, and axonal damage in MS patients.

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