Evaluating Fundoscopy as a Screening Tool for Optic Nerve Atrophy in Multiple Sclerosis: An Optical Coherence...

Area of Science:

• Ophthalmology
• Neurology
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a chronic central nervous system disorder involving inflammation, demyelination, and neurodegeneration.
• Optic neuritis (ON) affects over 70% of MS cases, often leading to optic nerve atrophy.
• Optic nerve atrophy in MS can manifest as optic disc pallor visible during fundoscopy.

Purpose of the Study:

• To evaluate the diagnostic capacity of fundus ophthalmoscopy in detecting optic nerve atrophy in MS patients.
• To compare fundus photography (FP) findings with optical coherence tomography (OCT) measurements of peripapillary retinal nerve fiber layer (pRNFL) thickness.
• To correlate optic disc pallor observed in FPs with structural parameters from OCT.

Main Methods:

• Analysis of 88 eyes from 44 relapsing-remitting MS patients.
• Utilized fundus photography (FP) and OCT optic disc measurements.
• Correlated temporal optic disc pallor in FPs with OCT-derived structural parameters.

Main Results:

• FP-based optic disc pallor grading demonstrated significant capacity to differentiate between normal and pale quadrants (p=0.006) and between light and moderate/strong pallor (p=0.002).
• The grading was less effective in distinguishing normal from light pallor (p=0.608) or between different degrees of pallor (p=0.33).
• FP showed significant ability to discriminate between specific categories of optic disc pallor in MS patients.

Conclusions:

• Fundoscopy and FP are valuable, widely available screening tools for optic nerve atrophy in MS.
• These methods can aid in assessing neurodegeneration associated with MS.
• Including the optic disc as part of the CNS could enhance understanding of MS progression and patient outcomes.