Evaluation of Retinal Structure and Optic Nerve Function Changes in Multiple Sclerosis: Longitudinal Study with 1-Year Follow-Up

Abstract

Background. Multiple sclerosis (MS) is an autoimmune disease characterized by inflammation and demyelination of the central nervous system which often involves the optic nerve even though only 20% of the patients experience optic neuritis (ON). Objective. This study aims to compare the retinal structure and optic nerve function between patients with MS and healthy controls (HCs), evaluate optic nerve alterations in MS over 1-year follow-up, and analyze its correlations with disease duration, number of relapses, degree of disability, and different subtypes. Methods. This is a prospective cohort study involving 58 eyes of MS patients. Optic nerve function was evaluated with best-corrected visual acuity (BCVA), contrast sensitivity, and P100 latency, while the retinal structure was evaluated from the GCIPL and RNFL thickness measured with optical coherence tomography (OCT) and fundus photography. Results. The MS group had lower BCVA ( p = 0.001 ), contrast sensitivity ( p < 0.001 ), mean GCIPL thickness ( p < 0.001 ), and mean RNFL thickness ( p < 0.001 ) than HC. At 6 and 12 months of observations, GCIPL and RNFL (nasal quadrant) of MS patients decreased significantly ( p = 0.007 and p = 0.004 , respectively). Disease duration and the number of relapses correlated with delayed P100 latency (r = −0.61, p < 0.001 and r = −0.46, p = 0.02 ). GCIPL and RNFL in the SPMS subtype were thinner than in RRMS. Conclusions. The retinal structure and optic nerve function of MS patients are worse than those of normal individuals. GCIPL and RNFL thinning occurs at 6 and 12 months but do not correlate with disease duration, the number of relapses, and degree of disability.

A Retrospective Cohort Study on the Difficulties of Diagnosing and Managing Glaucoma in Patients with Coexistent Neurodegenerative Disease

“…However, in studies of patients with MS, the optic nerve has been described to appear pale and atrophied, and patients with Parkinson's have been shown to have shallower cups compared to healthy controls. 39 , 40 Additionally, optic nerve pallor, increased CDR and cup volume, and decreased rim area have been reported in patients with Alzheimer's compared to healthy controls. 5 , 41 …”

Biomarkers in Progressive Multiple Sclerosis: An Updated Review

“…A. OCT Many studies have suggested OCT as a useful tool for detecting progression in patients with MS but not in PPMS patients [36], compared with controls Lower ganglion cellinner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and total macular volume (TMV) was found in patients with SPMS compared to RRMS [37]- [43] and is a beneficial tool to monitor the disability progression [38]. This shows that Longitudinal assessment of retinal thinning could confirm those patients who converted to SPMS.…”

Retinal imaging with optical coherence tomography in multiple sclerosis: novel aspects

“…Recent studies demonstrate conflicting data about the main focus of RNFL thinning. Depending on the cohort, temporal and nasal quadrants are most affected [ 28 , 29 ]. Furthermore, progressive thinning of the retinal ganglion cell (RGC) and the inner plexiform layer has also been described for relapsing–remitting MS (RRMS) [ 29 ].…”

“…Disease progression without a relapse, typical for primary progressive (PPMS) or secondary progressive MS (SPMS), is also associated with increased GCIPL and pRNFL thickness loss [ 40 ]. This could, to a certain extent, explain why progressive MS patients show faster annual pRNFL and GCIPL thinning and lower values at baseline compared to RRMS [ 28 , 41 – 43 ]. As mentioned before, GCIPL and pRNFL can be correlated with brain atrophy and spinal cord atrophy, cortical lesion volume, and leptomeningeal enhancement [ 44 – 48 ].…”