Subfoveal and Peripapillary Choroidal Assessment in Multiple Sclerosis with Unilateral Optic Neuritis

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Optic neuritis (ON) is a common initial symptom of MS, causing inflammation and damage to the optic nerve.
• Investigating ocular changes can provide insights into MS pathophysiology and progression.

Purpose of the Study:

• To evaluate subfoveal and peripapillary choroidal vascularity index (CVI) and peripapillary retinal nerve fiber layer (RNFL) thickness in MS patients with unilateral ON.
• To identify regional choroidal and retinal alterations associated with MS and ON.

Main Methods:

• Prospective study of 31 MS patients with recent unilateral ON and 73 healthy controls.
• Enhanced-depth imaging optical coherence tomography (EDI-OCT) used for subfoveal and peripapillary scans.
• Quantification of CVI and measurement of RNFL thickness, with statistical analysis comparing affected, unaffected fellow, and control eyes.

Main Results:

• Subfoveal CVI was significantly higher in both ON-affected (ON+) and unaffected fellow (ON-) eyes compared to controls.
• Peripapillary CVI did not differ significantly among the groups.
• Global and temporal RNFL thickness were reduced in both ON+ and ON- eyes compared to controls, with further reductions in superior, inferior, and nasal RNFL in ON+ eyes.

Conclusions:

• Elevated subfoveal CVI and reduced RNFL thickness are present in MS patients, even in the unaffected fellow eye.
• Peripapillary CVI may not be as sensitive to early MS-related changes as subfoveal CVI.
• Combined assessment of CVI and RNFL offers valuable structural information on neurovascular changes in MS.