Retinal microvascular and neuronal function in patients with multiple sclerosis: 2-year follow-up

Chen, Qi; Fang, Min; Miri, Shahnaz; Thakor, Kinjal; Delgado, Silvia; Hernandez, Jeffrey; Alba, Diego; Gregori, Giovanni; Porciatti, Vittorio; Wang, Jianhua; Jiang, Hong

doi:10.1016/j.msard.2021.103314

Cited by 2 publications

(2 citation statements)

References 69 publications

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“…As already discussed above, decreased retinal vessel densities have been linked to worse visual acuity and pronounced disability in cross-sectional studies (7). In line with this, a longitudinal parafoveal vessel loss has been described to be linked to increasing EDSS scores (32) whilst increased retinal vessel densities might be associated with a stable disease course and improved visual function (33). Thus, retinal OCT-A might be a useful tool to predict the future disease course in patients with early relapsing remitting multiple sclerosis.…”

Section: Discussionmentioning

confidence: 57%

Association of the retinal vasculature, intrathecal immunity, and disability in multiple sclerosis

et al. 2022

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BackgroundOptical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing remitting multiple sclerosis (RRMS), retinal vessel loss occurs in eyes suffering from acute optic neuritis and recent data suggest that retinal vessel loss might also be evident in non-affected eyes. We investigated whether alterations of the retinal vasculature are linked to the intrathecal immunity and whether they allow prognostication of the future disease course.Material and methodsThis study includes two different patient cohorts recruited at a tertiary German academic multiple sclerosis center between 2018 and 2020 and a cohort of 40 healthy controls. A total of 90 patients with RRMS undergoing lumbar puncture and OCT-A analysis were enrolled into a cross-sectional cohort study to search for associations between the retinal vasculature and the intrathecal immune compartment. We recruited another 86 RRMS patients into a prospective observational cohort study who underwent clinical examination, OCT-A and cerebral magnetic resonance imaging at baseline and during annual follow-up visits to clarify whether alterations of the retinal vessels are linked to RRMS disease activity. Eyes with a history of optic neuritis were excluded from the analysis.ResultsRarefication of the superficial vascular complex occured during RRMS and was linked to higher frequencies of activated B cells and higher levels of the pro-inflammatory cytokines interferon-γ, tumor necrosis factor α and interleukin-17 in the cerebrospinal fluid. During a median follow-up of 23 (interquartile range 14 - 25) months, vessel loss within the superficial (hazard ratio [HR] 1.6 for a 1%-point decrease in vessel density, p=0.01) and deep vascular complex (HR 1.6 for a 1%-point decrease, p=0.05) was associated with future disability worsening.DiscussionOptic neuritis independent rarefication of the retinal vasculature might be linked to neuroinflammatory processes during RRMS and might predict a worse disease course. Thus, OCT-A might be a novel biomarker to monitor disease activity and predict future disability.

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Section: Discussionmentioning

confidence: 57%

Association of the retinal vasculature, intrathecal immunity, and disability in multiple sclerosis

et al. 2022

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“…The introduction of optical coherence tomography angiography (OCTA) provided a noninvasive imaging technique to perform qualitative and quantitative analyses of the retinal vascular status in MS patients in different disease stages or in longitudinal studies ( 6 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

Correlation analysis between foveal avascular zone and near peripheral retinal hypoperfusion in multiple sclerosis: a wide field optical coherence tomography angiography study

Montorio

Cennamo²,

Carotenuto³

et al. 2022

Front. Med.

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The identification of non-invasive biomarkers to investigate and monitor retinal structural and vascular changes in multiple sclerosis (MS) represents an interesting source of debate. Until now optical coherence tomography angiography (OCTA) evaluated the foveal avascular zone (FAZ) and areas of retinal non-perfusion only in the macular region in MS patients. It could be interesting to identify possible biomarkers, useful in assessing the ischemic areas also in the near peripheral retina, since FAZ enlargement and the areas of peripheral retinal non-perfusions share common pathogenic processes. In this cross-sectional study, we investigated the correlation between the FAZ area and retinal vessel density (VD) in the near peripheral retina by new wide-field optical coherence tomography angiography (OCTA) in patients affected by relapsing-remitting multiple sclerosis (RR-MS). Moreover, we compared the FAZ area and the VD of superficial and deep capillary plexuses in the fovea region and in the near peripheral retina (6.4 × 6.4 mm) between RR-MS patients and healthy controls by means of a Solix full-range OCTA. Last, we also detected the changes in structural OCT parameters (ganglion cell complex and retinal nerve fiber layer). Thirty-three eyes of 33 RR-MS patients and 35 eyes of 35 healthy controls were enrolled. RR-MS patients showed a lower VD in the superficial capillary plexus and a significant increase in the FAZ area compared with controls. The deep capillary plexus revealed a reduced VD although not statistically significant in patients with respect to controls. In the patients' group, the FAZ area showed significantly negative correlations with VD of superficial capillary plexuses in the foveal and whole region, while the FAZ area did not negatively correlate with the VD of the deep capillary plexus. The significant correlations among OCTA parameters could demonstrate the FAZ area as a possible biomarker for assessing the perfusion status in the near peripheral retina, useful in RR-MS management. These findings could confirm the role of vascular dysfunction in the pathogenetic mechanisms of MS.

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Retinal microvascular and neuronal function in patients with multiple sclerosis: 2-year follow-up

Cited by 2 publications

References 69 publications

Association of the retinal vasculature, intrathecal immunity, and disability in multiple sclerosis

Association of the retinal vasculature, intrathecal immunity, and disability in multiple sclerosis

Correlation analysis between foveal avascular zone and near peripheral retinal hypoperfusion in multiple sclerosis: a wide field optical coherence tomography angiography study

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