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Outer Retinal Dysfunction in the Absence of Structural Abnormalities in Multiple Sclerosis.

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Multiple sclerosis (MS) patients show outer retinal dysfunction, even without visible structural changes in those retinal layers. Full-field electroretinogram (ERG) peak times, not amplitudes, are key for detecting this dysfunction in MS.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Multiple Sclerosis Research

Background:

  • Emerging evidence points to structural changes beyond the inner retina in multiple sclerosis (MS) patients.
  • The functional impact of these proposed outer retinal abnormalities in MS remains largely undetermined.

Purpose of the Study:

  • To investigate outer retinal function and structure in MS patients.
  • To quantify the influence of outer retinal structure on function in MS.
  • To explore potential primary retinal abnormalities in MS.

Main Methods:

  • Assessed outer retinal function using full-field and multifocal electroretinogram (ERG/MF-ERG).
  • Evaluated retinal structure with spectral-domain optical coherence tomography (OCT).
  • Analyzed correlations between electrophysiology parameters and OCT findings.

Main Results:

  • Most ERG responses in MS patients were delayed, irrespective of optic neuritis (ON) history.
  • Inner retinal thickness and volumes were reduced in eyes with prior ON; other OCT parameters were normal.
  • OCT results correlated with ERG amplitudes, but not with ERG peak times or MF-ERG parameters.

Conclusions:

  • Outer retinal dysfunction was observed in MS patients without corresponding detectable structural abnormalities.
  • Findings suggest primary retinal abnormalities distal to the inner retina may be more prevalent in MS than previously recognized.
  • Full-field ERG, particularly analysis of peak times, may be more valuable than MF-ERG for detecting retinal dysfunction in MS.