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Optical coherence tomography and angiography in multiple sclerosis: A systematic review and meta-analysis
Angeliki Filippatou1, Aikaterini Theodorou2, Maria-Ioanna Stefanou3
1Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Journal of the Neurological Sciences
|February 15, 2025
Summary
Optical coherence tomography (OCT) reliably quantifies retinal neuro-axonal damage in multiple sclerosis (MS). This review synthesizes OCT and OCT angiography findings, establishing thresholds for detecting optic nerve involvement in MS patients.
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Imaging
Background:
- Anterior visual pathway damage is common in multiple sclerosis (MS).
- Optical coherence tomography (OCT) assesses retinal nerve fiber layer (pRNFL) and ganglion cell inner plexiform layer (GCIPL) thickness.
- OCT angiography (OCTA) visualizes retinal microvasculature.
Purpose of the Study:
- To systematically review and synthesize OCT and OCTA findings in MS patients.
- To compare retinal structure and vasculature in MS patients with and without optic neuritis (ON) versus healthy controls (HC).
- To evaluate OCT's diagnostic yield for detecting unilateral optic nerve involvement in MS.
Main Methods:
- Systematic review and meta-analysis of studies using OCT and OCTA in MS patients.
- Included comparisons: MS-ON vs. HC, MS non-ON (MS-NON) vs. HC, and MS-ON vs. MS-NON.
- Analyzed pRNFL, GCIPL, inner nuclear layer (INL) thickness, and retinal vessel density.
Main Results:
- Meta-analysis included 170 OCT studies (8542 HC, 5529 MS-ON, 14,822 MS-NON eyes) and 24 OCTA studies (1344 HC, 505 MS-ON, 1168 MS-NON eyes).
- MS-ON and MS-NON eyes showed reduced pRNFL and GCIPL thickness and lower peripapillary and macular superficial vessel density compared to HC.
- INL thickness did not differ between HC and MS, but was greater in MS-ON than MS-NON eyes.
Conclusions:
- OCT enables reliable quantification of retinal neuro-axonal damage in MS.
- OCT findings can establish robust thresholds for detecting unilateral optic nerve involvement in MS.
- OCT and OCTA are valuable tools for assessing MS-related visual pathway damage.
Keywords:
Multiple sclerosisOptic nerveOptical coherence tomographyOptical coherence tomography angiographyRetinaMore Related Videos
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