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Retinal inter-eye difference and atrophy progression in multiple sclerosis diagnostics.

Jenny Nij Bijvank1,2, B M J Uitdehaag3, Axel Petzold3,2,4

  • 1Neurology, MS Center and Neuro-ophthalmology Expertise Center, Amsterdam Neuroscience, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands j.nijbijvank@amsterdamumc.nl.

Journal of Neurology, Neurosurgery, and Psychiatry
|November 12, 2021
PubMed
Summary
This summary is machine-generated.

Retinal asymmetry measurements, specifically inter-eye differences in macular ganglion cell and inner plexiform layer thickness, can help diagnose multiple sclerosis (MS) by demonstrating dissemination in space (DIS). This method shows diagnostic value for MS.

Keywords:
multiple sclerosisneuroophthalmology

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • The visual system's role in diagnosing multiple sclerosis (MS) for dissemination in space (DIS) and dissemination in time (DIT) is under investigation.
  • Retinal asymmetry may serve as a diagnostic marker in MS.

Purpose of the Study:

  • To evaluate the diagnostic utility of retinal asymmetry in individuals with MS.
  • To assess the stability of these measures over time.

Main Methods:

  • A prospective, longitudinal study involving 151 MS patients and 27 controls.
  • Optical coherence tomography (OCT) used to measure macular ganglion cell and inner plexiform layer (mGCIPL) thickness.
  • Analysis of inter-eye percentage difference (IEPD) and inter-eye absolute difference (IEAD) for retinal asymmetry.

Main Results:

  • High and stable diagnostic accuracy (AUCs 0.88-0.93) for IEPD and IEAD in differentiating MS optic neuritis.
  • IEPD demonstrated slightly superior performance compared to IEAD.
  • Atrophy rates had low discriminatory ability (AUC 0.49-0.58) between MS patients and controls.

Conclusions:

  • Inter-eye mGCIPL differences are valuable for demonstrating DIS in MS, but not DIT in long-standing MS.
  • Retinal asymmetry could be incorporated into future MS diagnostic criteria for DIS detection.
  • Further validation in large prospective studies is necessary.