Background: To evaluate retinal vessel density (VD) in macular and in peripapillary regions in patients with recent onset of multiple sclerosis, at initial demyelinating event (IDE) and in matched relapsing-remitting multiple sclerosis (RRMS) patients.Methods: We evaluated VD in superficial capillary plexus, deep capillary plexus, choriocapillaris and radial peripapillary capillary plexus in IDE, RRMS patients and in matched healthy controls (HCs) through Optical Coherence Tomography Angiography (OCT-A). Clinical history, including history of optic neuritis, Expanded Disability Status scale and disease duration of patients were collected.Results: Thirty patients (20 with IDE and 10 with RRMS) and 15 HCs were enrolled. IDE patients showed a lower VD in radial peripapillary capillary plexus compared with controls (coeff. β = −3.578; p = 0.002). RRMS patients displayed a lower VD in both superficial capillary plexus and radial peripapillary capillary plexus compared with HCs (coeff. β = −4.955; p = 0.002, and coeff. β = −7.446; p < 0.001, respectively). Furthermore, RRMS patients showed a decreased VD in radial peripapillary capillary plexus compared with IDE patients (coeff. β = −3.868; p = 0.003).Conclusions: Peripapillary region vessel density reduction, revealed through OCT-A, might be considered as an early event in MS, and might be relevant as a biomarker of disease pathology.

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Optical Coherence Tomography Angiography (OCTA) abnormalities occur in multiple sclerosis (MS) over the course of the disease. OCTA investigations at early MS stages are lacking. We aimed to investigate vessel density in macular and papillary regions over two years after an initial demyelinating event (IDE). Vessel density was analyzed in superficial, deep, choriocapillaris and radial peripapillary plexus at baseline, and after one and two years. We also evaluated structural OCT parameter changes of the ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). We evaluated 30 eyes from 15 IDE patients (7 females, 8 males, mean age 28.4 ± 9.6 years) and 30 eyes from 15 healthy controls. After 2 years, we reported in the IDE group a reduced vessel density in the superficial capillary plexus, deep capillary plexus and radial peripapillary capillary plexus with respect to the baseline (coeff. β = −2.779, p = 0.013; coeff. β = −4.055, p = 0.018 and coeff. β = −2.687, p ≤ 0.001; respectively), while GCC and RNFL thicknesses did not change. Vessel density reduction was not associated with an expanded disability status scale (EDSS) change, relapse occurrence or magnetic resonance imaging activity. The analysis of healthy controls did not reveal any impairment in OCT and OCTA parameters over 2 years of follow-up. Retinal vascular loss occurs in patients with an IDE independently from clinical and radiological disease activity. Retinal vessel density could represent a novel early biomarker to monitor the MS pathological burden.

Aim: To evaluate the dental effects of the treatment with clear aligners and intermaxillary elastics in adult patients with Class II malocclusion. Material and methods: A sample of 20 Class II patients treated with Invisalign aligners (5 M and 15 F; mean age of 27.6 ± 6.3 years) was included in this single-center one-group longitudinal study. Dental cast and cephalometric records were analyzed before (T0) and after treatment (T1). Data were analyzed with a T-test for paired data (p < 0.05). Results: There was a significant reduction of the Overjet (OVJ= −1.4 ± 0.2; p = <0.001) and a retroposition of upper incisors (U1-NPo = −1.3 ± 1.7; p < 0.001). Furthermore, distalization of upper molars with an improvement of molar class (U6-PT Vertical = −0.93 ± 0.97; p < 0.001; Molar Relation = −0.75 ± 0.45; p < 0.001) was observed. A good control of the lower and upper incisor inclination was present, highlighted by the non-significant changes in these values (L1-GoGn = −0.12 ± 5.4; p = 0.923; U1-AnsPns = −1.1 ± 8.1; p = 0.551). In the lower arch, an increase in the intermolar diameter (0.6 ± 1.0; p = 0.01) was present. Finally, there were no statistically significant changes in all the skeletal variables (ANPg = 0.005 ± 0.687; p = 0.974; SN/MP = −0.47 ± 1.9; p = 0.298). Conclusions: Treatment with Invisalign aligners shows a reduction of the Overjet, a retroposition of the upper incisors, good control of the lower incisors, and an improvement of the molar relationship.

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