OCT-Based Retina Assessment Reflects Visual Impairment in Multiple Sclerosis

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Visual impairment is common in MS, impacting quality of life.
• Optical Coherence Tomography (OCT) is a non-invasive imaging technique to assess retinal structure.

Purpose of the Study:

• To investigate the correlation between visual function and retinal layer thickness in people with MS (PwMS) compared to healthy controls (HC).
• To evaluate the efficacy of OCT in detecting visual impairment in PwMS.
• To compare different visual acuity tests and their association with retinal morphology.

Main Methods:

• Data collected from 137 PwMS and 118 HC at two neurology centers.
• Neurological, ophthalmological assessments, including OCT, high-contrast visual acuity (HCVA), low-contrast visual acuity (LCVA), and area under the log contrast sensitivity function (AULCSF).
• Follow-up assessments conducted after one year.

Main Results:

• PwMS showed reduced peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) volume compared to HC.
• Specific cutoffs for pRNFL thickness were associated with visual impairment (HCVA, LCVA, AULCSF).
• mGCIPL volume was most strongly associated with AULCSF, and AULCSF correlated best with both pRNFL and mGCIPL.

Conclusions:

• AULCSF is a sensitive measure of visual function, closely mirroring retinal atrophy.
• mGCIPL loss is a stronger indicator of neurodegeneration and visual impairment than pRNFL, without a cutoff effect.
• OCT, particularly mGCIPL measurement, is a valuable tool for assessing neuronal atrophy in MS.