Homonymous hemi-macular atrophy in multiple sclerosis.

Area of Science:

• Neuroscience
• Ophthalmology
• Clinical Neurology

Background:

• Retrograde trans-synaptic degeneration (TSD) can occur after retro-chiasmal damage in multiple sclerosis (MS).
• This degeneration may lead to homonymous hemi-macular atrophy (HHMA) in the ganglion cell/inner plexiform layer (GCIPL) of the retina.

Purpose of the Study:

• To investigate the prevalence of HHMA in people with MS (PwMS).
• To explore the association between HHMA and clinical outcomes, as well as retinal and radiological features in PwMS.

Main Methods:

• A cross-sectional study involving healthy controls (HC) and PwMS.
• Retinal optical coherence tomography (OCT) was used to quantify HHMA using a normalized asymmetry ratio.
• Propensity score matching and mixed-effects linear regression models were employed for analysis.

Main Results:

• HHMA was identified in 8.4% of PwMS (79 out of 942).
• HHMA eyes showed reduced GCIPL, inner nuclear, and outer nuclear layer thicknesses compared to non-HHMA eyes.
• PwMS with HHMA had higher disability scores (EDSS), worse visual acuity, and a greater frequency of microcystoid macular changes.

Conclusions:

• HHMA is present in a notable percentage of individuals with MS.
• HHMA may serve as a potential biomarker for TSD in MS.
• The presence of HHMA may indicate increased disability in PwMS.