Macular OCT's Proficiency in Identifying Retrochiasmal Visual Pathway Lesions in Multiple Sclerosis-A Pilot Study

Area of Science:

• Ophthalmology
• Neurology
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a neurodegenerative disease impacting the central nervous system.
• Optic nerve and retinal damage in MS can be visualized using Optical Coherence Tomography (OCT).
• Retrochiasmal lesions in the visual pathway are challenging to detect.

Purpose of the Study:

• To evaluate macular OCT as a potential biomarker for detecting retrochiasmal lesions in MS patients.
• To compare the efficacy of OCT with visual field (VF) testing in identifying these lesions.

Main Methods:

• A prospective study included 52 MS patients and 27 healthy controls.
• Participants underwent brain MRI, visual field testing, and OCT of the peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell layer (GCL), and macular inner plexiform layer (IPL).
• OCT measurements were adjusted for optic neuritis (ON).

Main Results:

• Visual field testing showed limited capability in detecting retrochiasmal lesions identified by MRI (PPV 0.50).
• Macular OCT analysis demonstrated superior performance in identifying retrochiasmal MS lesions compared to VF.
• Alterations in GCL and IPL thickness were the most accurate indicators of retrochiasmal visual pathway changes.

Conclusions:

• Macular OCT is a promising tool for identifying retrochiasmal lesions in MS.
• OCT measurements of GCL and IPL offer a more sensitive method than VF testing for detecting visual pathway damage in MS patients.