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Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...

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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.

Revue Neurologique
|March 8, 2024
PubMed
Summary

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.

Keywords:
BiomarkerMultiple sclerosisOCT-AngiographyOptical coherence tomographyPrognosis

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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.