BACKGROUND AND PURPOSE: Optical coherence tomography (OCT) has shown thinning of the retinal nerve fibre layer (RNFL) and total macular volume (TMV) in multiple sclerosis (MS) patients. Measures of retinal atrophy are associated with the brain parenchymal fraction (BPF) assessed by magnetic resonance imaging (MRI). However, in MS, data on the relation of OCT measures and grey and white matter volumes are contradictory. We performed a prospective cross-sectional study with a statistically pre-defined endpoint to test our hypothesis that OCT measures of neuro-axonal degeneration are related to global and partial brain atrophy in early forms of MS. METHODS AND RESULTS: Fortyfour patients with clinically isolated syndrome (n = 10) or relapsing-remitting MS (n = 34; mean disease duration = 3.2 years, median EDSS = 1.5) were enrolled in the study. Peripapillary-and volumetric OCT scans of the macula were performed using latest spectral-domain OCT technology. BPF as well as white and grey matter fractions (WMF/GMF) were assessed by 1.5 Tesla MRI scans. Generalized estimating equation models adjusted for age and linear regression statistics were used to assess the association between OCT and MRI measures. RNFL thickness, TMV and age were significantly associated with BPF. RNFL thickness and TMV independently predicted WMF (P = 0.003 and P = 0.032) but not GMF (P = 0.717 and P = 0.357) when corrected for age. In contrast, age was strongly associated with GMF (P < 0.001) but not WMF. CONCLUSION: Our study suggests that, in early MS, OCT measures of retinal atrophy are related to volumetric changes in the white but not grey matter compartment as assessed by MRI. It further substantiates the association of retinal thinning and brain tissue loss in MS. We performed a cross-sectional study with a statistically pre-defined endpoint to test our hypothesis that OCT measures of neuro-axonal degeneration are related to global and partial brain atrophy in early forms of MS.44 patients with clinically isolated syndrome (CIS, n=10) or relapsing remitting MS (RRMS, n=34) (mean disease duration=3.2 years, median EDSS=1.5) were enrolled in the study. Peripapillary-and volumetric OCT scans of the macula were performed using latest spectral-domain OCT technology. BPF as well as white and grey matter fractions (WMF/GMF) were assessed by 1.5 T MRI scans. Generalized estimating equation models (GEE) adjusted for age and linear regression statistics were used to assess the association between OCT and MRI measures.RNFL thickness, TMV and age were significantly associated with BPF. RNFL thickness, and TMV independently predicted WMF (p=0.003 and p=0.032) but not GMF (p=0.717 and p=0.357) when corrected for age. In contrast, age was strongly associated with GMF (p<0.001) but not WMF.

Objective T2′ imaging has been shown to be sensitive to oxygen saturation changes in normal appearing white and grey matter (NAWM, NAGM) in patients with relapsing-remitting multiple sclerosis (RRMS). We aimed to explore the presence and extent of T2′ changes in patients with a clinically isolated syndrome (CIS) and a possible association of T2′ with conventional MRI and clinical outcomes. Material & methods Quantitative T2- and T2*-weighted images were acquired in 32 treatment-naive patients with a CIS within 3 months of presentation and 15 age-matched healthy controls (HC). Quantitative T2′ values were determined in six regions of interest (ROIs). Results T2′ values in CIS did not differ significantly from those in HC. Among patients, T2′ values correlated positively with the T2 lesion volume (T2LV, r=0.34, p<0.05). T2′ values of the frontal NAWM correlated with the T2LV (r=0.35, p<0.05) and T2 lesion count (r=0.4, p=0.02). Conclusion As opposed to RRMS, patients with CIS did not show T2′ alterations compared to HC. However, the association between the T2LV and higher T2′ values suggests that T2′ reflects disease evolution. In CIS metabolic changes might be masked by compensatory mechanisms and become overt when disease progresses as has been shown for RRMS patients.