Related Experiment Video
Updated: May 6, 2026
Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
Evolution of retinal degeneration and prediction of disease activity in relapsing and progressive multiple sclerosis
Julia Krämer1, Carolin Balloff2,3, Margit Weise2
1Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany. julia.kraemer@ukmuenster.de.
Abstract:
Retinal optical coherence tomography has been identified as biomarker for disease progression in relapsing-remitting multiple sclerosis (RRMS), while the dynamics of retinal atrophy in progressive MS are less clear. We investigated retinal layer thickness changes in RRMS, primary and secondary progressive MS (PPMS, SPMS), and their prognostic value for disease activity. Here, we analyzed 2651 OCT measurements of 195 RRMS, 87 SPMS, 125 PPMS patients, and 98 controls from five German MS centers after quality control. Peripapillary and macular retinal nerve fiber layer (pRNFL, mRNFL) thickness predicted future relapses in all MS and RRMS patients while mRNFL and ganglion cell-inner plexiform layer (GCIPL) thickness predicted future MRI activity in RRMS (mRNFL, GCIPL) and PPMS (GCIPL). mRNFL thickness predicted future disability progression in PPMS. However, thickness change rates were subject to considerable amounts of measurement variability. In conclusion, retinal degeneration, most pronounced of pRNFL and GCIPL, occurs in all subtypes. Using the current state of technology, longitudinal assessments of retinal thickness may not be suitable on a single patient level.
Insights
Optical coherence tomography reveals retinal degeneration in all multiple sclerosis (MS) subtypes. While retinal nerve fiber layer thickness can predict disease activity, current technology limits its use for individual patient monitoring.
Area of Science:
- Ophthalmology
- Neurology
- Biomarkers
Background:
- Retinal optical coherence tomography (OCT) is a known biomarker for disease progression in relapsing-remitting multiple sclerosis (RRMS).
- The dynamics of retinal atrophy in progressive forms of multiple sclerosis (MS) are less understood.
- Investigating retinal layer thickness changes and their prognostic value across different MS subtypes is crucial.
Purpose of the Study:
- To analyze retinal layer thickness changes in RRMS, primary progressive MS (PPMS), and secondary progressive MS (SPMS).
- To evaluate the prognostic value of these changes for disease activity and progression.
- To assess the suitability of longitudinal OCT assessments for individual patient monitoring.
Main Methods:
- Analysis of 2651 OCT measurements from 195 RRMS, 87 SPMS, 125 PPMS patients, and 98 controls.
- Data collected from five German MS centers after quality control.
- Assessment of peripapillary and macular retinal nerve fiber layer (pRNFL, mRNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness.
Main Results:
- pRNFL and mRNFL thickness predicted future relapses in all MS and RRMS patients.
- mRNFL and GCIPL thickness predicted future MRI activity in RRMS and PPMS.
- mRNFL thickness predicted future disability progression in PPMS.
- Significant retinal degeneration, particularly in pRNFL and GCIPL, was observed across all MS subtypes.
Conclusions:
- Retinal degeneration occurs in all MS subtypes, with pRNFL and GCIPL most affected.
- Retinal layer thickness shows prognostic value for relapses, MRI activity, and disability progression.
- Current OCT technology exhibits considerable measurement variability, limiting its suitability for longitudinal assessments at the individual patient level.
