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Retinal Layer Thickness for Risk Stratification of Progression Independent of Relapse Activity in Relapsing-Remitting
Andre Braginets1,2, Frederike Cosima Oertel1,2,3, Eva-Maria Strauß4
1Experimental and Clinical Research Center, a Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité-Universitätsmedizin Berlin, Berlin, Germany.
Optical coherence tomography (OCT) measures of retinal neuroaxonal damage do not reliably predict progression independent of relapse activity (PIRA) in people with relapsing-remitting multiple sclerosis (pwRRMS). However, peripapillary retinal nerve fiber layer thickness showed prognostic value in an early disease cohort.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Identifying individuals with relapsing-remitting multiple sclerosis (pwRRMS) at risk of progression independent of relapse activity (PIRA) is a significant clinical challenge.
- Optical coherence tomography (OCT) measures of retinal neuroaxonal damage are being explored for their prognostic potential in MS.
- This study investigated the predictive value of peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer (GCIP) thickness for PIRA in pwRRMS.
Purpose of the Study:
- To evaluate whether pRNFL and GCIP thickness can predict PIRA in a heterogeneous group of pwRRMS.
- To determine the prognostic value of OCT-derived retinal measures for predicting disability worsening independent of relapses.
Main Methods:
- Retrospective analysis of 220 pwRRMS from observational cohorts in Berlin and Munich with at least 2 years of relapse-free follow-up.
- PIRA was defined as sustained disability worsening based on multimodal assessments.
- Cox hazard models assessed the association between age-adjusted pRNFL or GCIP Z-scores and PIRA in non-optic neuritis eyes.
Main Results:
- Out of 220 pwRRMS, 29.5% developed PIRA over a median follow-up of 2.9 years.
- No significant association between OCT measures and PIRA was observed in the overall population or the Munich cohort.
- In the Berlin cohort, thinner pRNFL thickness was a significant predictor of PIRA (aHR = 1.41, p = 0.032), while GCIP thickness did not predict PIRA.
Conclusions:
- OCT measurements, including pRNFL and GCIP thickness, generally do not predict PIRA in a heterogeneous group of pwRRMS.
- pRNFL thickness may hold prognostic value in specific subgroups, potentially in earlier disease stages.
- Further research is needed to explore the influence of clinical characteristics on the association between OCT measures and PIRA.
