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Functional and structural readouts for early detection of retinal involvement in multiple sclerosis
Khaldoon O Al-Nosairy1, Alexander Duscha2, Henrike Buhr1
1Department of Ophthalmology, University Hospital Magdeburg, Magdeburg, Germany.
Frontiers in Integrative Neuroscience
|May 4, 2023
Summary
Retinal electrophysiology detects multiple sclerosis (MS) damage independent of optic neuritis, revealing early inflammatory changes. These functional measures offer sensitive biomarkers for MS diagnostics and monitoring interventions.
Area of Science:
- Neuroscience
- Ophthalmology
- Immunology
Background:
- The retina offers a unique window into the central nervous system (CNS), enabling the study of neurodegenerative and inflammatory diseases like multiple sclerosis (MS).
- MS, a CNS autoimmune disease, frequently affects the visual system, including the retina, making it a key area for investigation.
- Current diagnostic approaches for MS-related retinal damage often rely on structural imaging, potentially missing earlier functional changes.
Purpose of the Study:
- To develop and validate novel functional retinal measures for detecting MS-related damage.
- To compare the sensitivity of retinal electrophysiology with established structural imaging markers (OCT) in individuals with MS.
- To investigate whether functional retinal changes occur independently of optic neuritis history in MS patients.
Main Methods:
- Inclusion of 37 individuals with MS (17 without optic neuritis history (NON), 20 with optic neuritis history (HON)) and 20 healthy controls (HC).
- Assessment of retinal function using multifocal electroretinography (mfERG) to evaluate photoreceptor/bipolar cells and retinal ganglion cells (RGCs).
- Structural assessment using optical coherence tomography (OCT) to measure peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell inner plexiform layer (GCIPL) thickness.
Main Results:
- Individuals with MS without optic neuritis (NON) showed impaired photoreceptor/bipolar cell function (mfERG) despite preserved structure.
- Both NON and individuals with MS with optic neuritis history (HON) exhibited abnormal RGC function (mfPhNR, mfPERG).
- Structural damage (GCIPL, pRNFL thinning) was primarily observed in HON, while functional deficits were detected in both NON and HON groups. All modalities differentiated MS from HC with 71-81% accuracy.
Conclusions:
- Functional retinal measures, particularly electrophysiology, detect MS-related damage independently of optic neuritis history, suggesting early retinal inflammation.
- Retinal electrophysiology serves as a sensitive biomarker for MS, potentially preceding structural changes and optic neuritis.
- These findings underscore the importance of incorporating retinal electrophysiology into MS diagnostics and monitoring therapeutic interventions.
