Optical coherence tomography and its use in optical neuritis and multiple sclerosis

Optical coherence tomography is a relatively new non-invasive imaging technique used for obtaining the images and quantifying the layers of the retina. It also provides information about optic nerve head topography, peripapillary retinal nerve fiber layer thickness, and macular volume which correlates with axonal loss. Until now, this method was used mainly in ophthalmology; now it has emerged as relevant in neurology as well. RNFL thickness is of particular interest in optic neuropathies and in multiple sclerosis. In sclerosis multiplex, axonal loss occurs as early as the first stages and the quantification of the RNFL thickness by OCT provides an indirect measure of axonal and neuronal loss in the anterior visual pathways. Because OCT is noninvasive, easy to obtain, and highly reproducible, it can be used as a marker of axonal loss and as an endpoint in clinical trials. This paper presents a comprehensive summary of the use of this new diagnostic method in multiple sclerosis patients (Fig. 1, Ref. 58).