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Retinal measurements predict 10-year disability in multiple sclerosis.

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Lower total macular volume (TMV) measured by optical coherence tomography (OCT) in multiple sclerosis (MS) patients predicts greater long-term disability. This finding aids in understanding MS progression and patient outcomes.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Radiology

Background:

  • Optical coherence tomography (OCT) measures retinal structure, correlating with neurological conditions like multiple sclerosis (MS).
  • Previous studies show OCT-derived retinal measures correlate with current disability and brain atrophy in MS.
  • The predictive value of baseline OCT measures for long-term disability in MS remains unclear.

Purpose of the Study:

  • To determine if a single OCT measurement and visual function test can predict disability status 10 years later in individuals with MS.
  • To investigate the association between baseline retinal nerve fiber layer thickness, total macular volume (TMV), and low-contrast letter acuity (LCLA) with long-term Expanded Disability Status Scale (EDSS) scores.

Main Methods:

  • 172 individuals with MS underwent Stratus time-domain OCT imaging and LCLA testing between 2006-2008.
  • Baseline TMV, peripapillary retinal nerve fiber layer (pRNFL) thickness, and LCLA were assessed.
  • Generalized linear regression models were used to evaluate associations with 10-year EDSS scores and clinically significant EDSS worsening, adjusting for covariates.

Main Results:

  • Lower baseline TMV was significantly associated with higher 10-year EDSS scores (mean increase of 0.75 EDSS per 1 mm³ loss in TMV).
  • Individuals in the lowest tertile of baseline TMV had significantly higher average EDSS scores and over 3.5-fold increased odds of clinically significant EDSS worsening at 10 years.
  • pRNFL thickness and LCLA predicted 10-year EDSS scores only in univariate analyses.

Conclusions:

  • Reduced baseline TMV measured by OCT is a significant predictor of higher long-term disability in MS.
  • OCT-derived TMV provides valuable prognostic information for MS disability progression, independent of baseline disability.
  • These findings highlight the potential of OCT as a tool for predicting long-term outcomes in MS management.