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Retinal optical coherence tomography measures in multiple sclerosis: a systematic review and meta-analysis
Nabil K El Ayoubi1, Ali Ismail2,3, Fares Fahd1
1Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut, Beirut, Lebanon.
Spectral domain-optical coherence tomography reveals significant retinal thinning in multiple sclerosis (MS) patients compared to healthy controls. Key measures like peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (GCIPL) show notable reductions, indicating MS-related neurodegeneration.
Area of Science:
- Ophthalmology
- Neurology
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
- Optical coherence tomography (OCT) is a non-invasive imaging technique that allows for in vivo cross-sectional visualization of retinal layers.
- Retinal neuroaxonal damage is increasingly recognized as a biomarker for MS pathophysiology and progression.
Purpose of the Study:
- To quantify differences in retinal layer thickness and macular volume between various multiple sclerosis (MS) groups and healthy controls (HC).
- To explore variables correlating with observed retinal changes in MS patients.
- To provide a meta-analysis of existing studies on OCT measures in MS.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Google Scholar following PRISMA guidelines.
- Meta-analyses were performed to assess mean differences in retinal layer thickness and macular volume.
- Meta-regression analyses were employed to investigate sources of heterogeneity, including disease duration, age, EDSS score, and treatment status.
Main Results:
- Significant thinning of peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (GCIPL) was observed in MS patients across different subtypes compared to HC.
- Specific findings include reduced pRNFL in MSON, MSNON, and PMS groups, and reduced GCIPL in MSON, MSNON, and PMS groups.
- Inner nuclear layer (INL) was thicker in MSON, while outer nuclear layer (ONL) was thinner in MSNON compared to HC. Disease duration, age, EDSS, and DMT use negatively correlated with pRNFL and GCIPL thickness.
Conclusions:
- Spectral domain-OCT demonstrates substantial thinning in pRNFL and macular GCIPL in individuals with MS compared to controls, reflecting neurodegeneration.
- The inner nuclear layer (INL) may serve as a valuable parameter for assessing inflammatory activity in MS.
- Retinal layer thickness in MS is influenced by disease duration, age, disability, and treatment, with female gender associated with less atrophy.
