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Retinal changes in multiple sclerosis: An optical coherence tomography and angiography study
S Mrabet1, Y Falfoul2, M Bouassida3
1Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, 2010 Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia.
Structural optical coherence tomography (OCT) and OCT-angiography (OCT-A) reveal thinner retinal layers and reduced vascular density in multiple sclerosis (MS) patients, correlating with disease severity and visual function.
Area of Science:
- Neuroscience
- Ophthalmology
- Immunology
Background:
- Multiple sclerosis (MS) is a central nervous system autoimmune disease causing neuroaxonal damage and disability.
- Visual symptoms, including optic neuritis (ON), are common in MS.
- Optical coherence tomography (OCT) and OCT-angiography (OCT-A) are advanced imaging techniques for assessing retinal changes.
Purpose of the Study:
- To evaluate structural and microvascular retinal changes in MS patients with and without a history of ON.
- To correlate these retinal findings with visual function and MS disability.
- To explore OCT and OCT-A as potential biomarkers for MS severity.
Main Methods:
- A cross-sectional study involving MS patients and healthy controls.
- Neurological assessment including Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS).
- Ophthalmological examination using OCT for retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL++) thickness, and OCT-A for retinal vascular density.
Main Results:
- MS patients showed decreased RNFL and GCL++ thickness compared to controls.
- Retinal layer thinning was more pronounced in MS patients with a history of ON.
- OCT-A revealed reduced vascular density in the superficial capillary plexus (SCP) in MS patients.
- Correlations were found between RNFL thickness and vascular density, visual acuity and choriocapillaris (CC) density, and EDSS/MSSS scores with CC density and RNFL/GCL++ thicknesses.
Conclusions:
- Retinal nerve fiber layer (RNFL) and ganglion cell complex (GCL++) layers are thinner in MS patients, especially those with prior optic neuritis (ON), and correlate with disease severity.
- Retinal vascular changes are present in MS patients, even without ON history.
- Choriocapillaris (CC) density is inversely correlated with visual function and disability.
- Structural OCT and OCT-A serve as noninvasive biomarkers for MS severity and progression.
