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Retinal microvascular and neuronal function in patients with multiple sclerosis: 2-year follow-up
Qi Chen1, Min Fang2, Shahnaz Miri3
1School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States.
Multiple Sclerosis and Related Disorders
|October 11, 2021
Summary
This study tracked retinal changes in relapsing-remitting multiple sclerosis (RRMS) patients for two years. Some retinal functions declined, but improved microcirculation was seen in patients with no evidence of disease activity (NEDA).
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Imaging
Background:
- Relapsing-remitting multiple sclerosis (RRMS) is a chronic neurological disease affecting the central nervous system.
- Retinal changes can serve as a surrogate marker for neurodegeneration in MS.
- Longitudinal assessment of retinal structure and function in RRMS is crucial for understanding disease progression.
Purpose of the Study:
- To longitudinally evaluate changes in retinal microstructure, microvasculature, microcirculation, and axonal/neuronal functions in RRMS patients over approximately two years.
- To identify potential imaging biomarkers for monitoring disease progression and treatment response in RRMS.
- To correlate retinal findings with clinical outcomes and disease activity.
Main Methods:
- Prospective study of 30 RRMS patients (60 eyes) over 27 ± 6 months.
- Utilized optical coherence tomography (OCT) for retinal thickness and polarization-sensitive OCT for axonal function.
- Assessed microvasculature with OCT angiography (volumetric vessel density - VVD) and microcirculation with retinal function imager (retinal tissue perfusion - RTP).
- Included clinical tests like low contrast letter acuity (LCLA) and pattern electroretinography (PERG).
Main Results:
- Significant decrease in axonal function (retinal nerve fiber layer birefringence) and deep vascular plexus vessel density at 2-year follow-up (P < 0.05).
- Increased retinal blood flow volume observed in patients with no evidence of disease activity (NEDA) and stable/improved visual function (P < 0.05).
- No significant changes in Expanded Disability Status Scale, LCLA, RTP, VVD, or PERG measures between visits (P > 0.05).
Conclusions:
- This is the first 2-year prospective study comprehensively assessing retinal microstructure and neuronal functions in RRMS.
- Recovery of retinal microcirculation in NEDA patients suggests its potential as an imaging biomarker for monitoring MS progression.
- Retinal imaging biomarkers may offer valuable insights into neurodegenerative processes and therapeutic efficacy in RRMS.
