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Paramagnetic rim lesions are associated with inner retinal layer thinning and progression independent of relapse

Nik Krajnc1,2, Leo Hofer2,3, Fabian Föttinger1,2

  • 1Department of Neurology, Medical University of Vienna, Vienna, Austria.

European Journal of Neurology
|November 12, 2024
PubMed
Abstract

Insights

Paramagnetic rim lesions (PRLs) in multiple sclerosis (MS) correlate with retinal nerve fiber layer thinning. This combination indicates a higher risk of progression independent of relapse activity (PIRA) in patients with MS.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Radiology

Background:

  • Paramagnetic rim lesions (PRLs) signify active inflammation in multiple sclerosis (MS).
  • PRLs are linked to a more severe disease trajectory in patients with MS (pwMS).

Purpose of the Study:

  • To investigate the association between retinal layer thinning and PRLs in pwMS.
  • To determine if retinal layer thinning and PRLs predict progression independent of relapse activity (PIRA).

Main Methods:

  • Included 97 pwMS with brain MRI and at least two optical coherence tomography (OCT) scans.
  • Used Cox proportional hazard regression to analyze the relationship between annualized loss of peripapillary retinal nerve fiber layer (aLpRNFL), annualized loss of ganglion cell-inner plexiform layer (aLGCIPL), PRLs, and PIRA.

Main Results:

  • The number of PRLs correlated with both aLpRNFL and aLGCIPL.
  • PIRA occurred in 18.6% of pwMS.
  • aLpRNFL, aLGCIPL, and the number of PRLs were independently associated with an increased risk of PIRA.

Conclusions:

  • PRLs are associated with inner retinal layer thinning.
  • PRLs and retinal layer thinning together may identify pwMS at high risk for disability progression.
Keywords:
GCIPLPIRAiron rimmultiple sclerosispRNFL

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