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Retinal thinning differentiates treatment effects in relapsing multiple sclerosis below the clinical threshold
Gabriel Bsteh1,2, Harald Hegen3, Nik Krajnc1,2
1Department of Neurology, Medical University of Vienna, Vienna, Austria.
Annals of Clinical and Translational Neurology
|December 17, 2024
Summary
Retinal layer thinning can identify disease-modifying treatment (DMT) effects in relapsing multiple sclerosis (RMS). This biomarker shows significant differences between various DMTs, even in clinically stable patients, aiding in monitoring treatment efficacy.
Area of Science:
- Neuroscience
- Ophthalmology
- Clinical Neurology
Background:
- Relapsing multiple sclerosis (RMS) is a chronic neurological condition.
- Disease-modifying treatments (DMTs) aim to slow disease progression.
- Objective biomarkers are needed to assess DMT efficacy in RMS.
Purpose of the Study:
- To evaluate retinal layer thinning as a biomarker for DMT effects in RMS.
- To compare the efficacy of different DMTs using retinal layer thinning rates.
Main Methods:
- Prospective observational study of 291 RMS patients.
- Optical coherence tomography (OCT) used to measure peripapillary-retinal-nerve-fiber-layer (pRNFL) and macular ganglion cell-plus-inner plexiform-layer (GCIPL) thinning.
- Mixed-effects linear regression analyzed differences in thinning rates between DMTs, excluding eyes with optic neuritis.
Main Results:
- Annualized retinal layer thinning rates varied significantly across different DMTs.
- Nataizumab (NTZ) and anti-CD20 therapies showed significantly lower thinning rates compared to other DMTs.
- Lower thinning rates were observed in patients achieving no evidence of disease activity (NEDA-2).
Conclusions:
- Retinal layer thinning, assessed using a rebaselining concept, can differentiate DMT effects in RMS.
- This method may serve as a valuable biomarker for monitoring DMT efficacy on subclinical neuroaxonal degeneration.
- The findings highlight the potential of OCT-based biomarkers in managing RMS.
