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Inner retinal layer thinning in radiologically isolated syndrome predicts conversion to multiple sclerosis
L Aly1,2, J Havla3,4, G Lepennetier1,2
1Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
European Journal of Neurology
|June 27, 2020
Summary
Optical coherence tomography (OCT) can predict multiple sclerosis (MS) conversion in individuals with radiologically isolated syndrome (RIS). Thinning of the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCIP) indicates a higher risk of MS conversion.
Area of Science:
- Neuro-ophthalmology
- Neuroimmunology
- Radiology
Background:
- Radiologically isolated syndrome (RIS) presents an elevated risk for developing multiple sclerosis (MS).
- Early identification of individuals with RIS who will convert to MS is critical for timely treatment initiation.
Purpose of the Study:
- To evaluate the predictive value of optical coherence tomography (OCT) measurements for MS conversion in individuals with RIS.
- To assess whether OCT parameters can aid in risk stratification for MS development.
Main Methods:
- A prospective observational cohort study involving 36 individuals with RIS and 36 healthy controls.
- Baseline and longitudinal follow-up (up to 6 years) included OCT imaging and clinical examinations.
- Primary outcome was conversion from RIS to clinically diagnosed MS.
Main Results:
- Eight of 36 individuals with RIS converted to MS during a median follow-up of 25-58 months.
- Baseline thinning of the peripapillary retinal nerve fiber layer (pRNFL) and the common ganglion cell and inner plexiform layer (GCIP) was observed in converters.
- Reduced pRNFL (<99 µm) or GCIP (<1.99 mm³) at baseline conferred a 7.5- to 8.0-fold increased risk of MS conversion.
- Each 1 µm decline in pRNFL correlated with a 1.08-fold increased hazard for MS conversion, independent of other risk factors.
Conclusions:
- Peripapillary retinal nerve fiber layer (pRNFL) reduction is a potential novel and independent risk factor for MS conversion in RIS.
- Optical coherence tomography (OCT) may serve as a valuable tool for risk stratification and guiding therapeutic decisions in individuals with RIS.
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