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

Abstract

SummaryOptical coherence tomography (OCT) is of increasing interest in the clinical assessment of multiple sclerosis (MS) patients beyond the scope of clinical studies. In this narrative review, we discuss novel changes of OCT parameters during acute optic neuritis and the disease course of MS patients. OCT images document the changes of retinal layers during an episode of acute optic neuritis and can therefore provide valuable insights into the pathophysiology. Moreover, MS patients show progredient thinning of retinal layers throughout the disease. The thinning is accelerated through relapses as well as disease progression without relapse. The OCT parameters are also associated with clinical outcome parameters, including disability, cognitive function, and brain atrophy. The impact of disease-modifying therapies on OCT parameters is the subject of ongoing research and depends on the agent used. Additional data are still necessary before OCT parameters can be implemented in the clinical standard of care of MS patients.

Swept-Source Optical Coherence Tomography Thresholds in Differentiating Clinical Outcomes in a Real-World Cohort of Treatment-Naïve Multiple Sclerosis Patients

“…These data are particularly important when analyzing the impact of the single-time-point OCT measurements on MS-related neurodegeneration independent of DMTs and ON history. Furthermore, we used SS-OCT imaging, the newest generation of OCT machines that allow greater retinal tissue penetration compared to SD-OCT [ 41 ]. Although SS-OCT is a promising diagnostic approach in pwMS, pRNFL and GCIPL thickness cut-offs have not yet been evaluated using such devices [ 42 ].…”

Artificial Intelligence and Multiple Sclerosis: Up-to-Date Review

“…Another field of AI in MS diagnosis is optical coherence tomography (OCT), which is usually used to detect optic neuritis in MS patients. Through time, MS patients show progressive thinning of retinal layers, accelerated by relapses and disease progression [ 42 ]. A recent review describes the adaptation of OSCAR-IB criteria, used for OCT quality control, to incorporate AI [ 43 , 44 ].…”

“…Several machine learning models (MLMs) distinguish successfully MS patients from healthy controls (e.g., support vector machines {SVMs} and decision trees) [ 45 ]. Moreover, two recent studies evaluated prognostic markers in MS using MLMs on small sample sizes, they got ambitious results with automated image pattern recognition [ 42 , 44 , 45 ].…”

Multiple sclerosis at the crossroads of scientific evidence and clinical translation

“…This special issue on MS comprises eight articles dealing with emerging developments in MS by experts from Austria, Germany, and Switzerland. The narrative review by Elisabeth Olbert and Walter Struhal (Tulln, Austria) deals with the emerging value of optical coherence tomography (OCT) in MS, not only for monitoring the consequences of optic neuritis [1]: their article also highlights the relevance of OCT parameters for predicting clinical outcomes, including disability, cognitive function, and brain atrophy. The current gold standard to detect intrathecal inflammation is determining cerebrospinal fluid (CSF)restricted oligoclonal bands (OCB).…”