Correlation between Retinal Vascularization and Disease Aggressiveness in Amyotrophic Lateral Sclerosis

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Neurodegenerative diseases often exhibit retinal abnormalities.
• Conflicting results exist regarding retinal changes in Amyotrophic Lateral Sclerosis (ALS).
• Optical coherence tomography (OCT) offers advanced imaging of retinal structures.

Purpose of the Study:

• To systematically analyze retinal layers and vascularization in ALS patients using spectral-domain OCT (SD-OCT) and OCT angiography (OCT-A).
• To investigate potential correlations between OCT parameters and ALS disease progression and activity.

Main Methods:

• 48 ALS patients and 45 healthy controls underwent SD-OCT and OCT-A examinations.
• ALS patients were stratified into slow, intermediate, and fast progressors.
• Evaluated parameters included subfoveal choroidal thickness (SFCT), ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), and OCT-A metrics (vessel density, foveal avascular zone).

Main Results:

• No significant differences in GCC and RNFL thickness were observed between ALS patients and controls, or among ALS progression groups.
• SFCT was significantly greater in ALS patients than in controls (p < 0.001).
• SFCT was notably thicker in slow and intermediate progressors compared to fast progressors (p < 0.001), and correlated with ALSFRS-r (r = 0.753, p = 0.024).
• OCT-A revealed no significant findings.

Conclusions:

• Choroidal thickness, specifically SFCT, is associated with disease activity in ALS.
• SD-OCT shows potential as a non-invasive biomarker for monitoring ALS progression and management.
• Further research is warranted to validate OCT as a clinical tool for ALS.