Photo Credit: miodrag ignjatovic
Optical coherence tomography is beneficial for measuring visual changes and the impact of comorbidities in MS, NMOSD, and other demyelinating disorders.
Compared with peripapillary retinal nerve fiber layer, ganglion cell layer and inner plexiform layer measurements are more reliable biomarkers for assessing visual prognosis in patients with multiple sclerosis (MS), according to results published in Beyoglu Eye Journal (BEJ).
In a cross-sectional, retrospective study, researchers aimed to assess retinal inner layer thicknesses in patients with MS, both with and without optic neuritis (ON), and to investigate the relationship with visual prognosis.
Investigators obtained retinal layer measurements using Heidelberg Spectralis optical coherence tomography (OCT), including macular retinal nerve fiber layer, ganglion cell layer (GCL), inner plexiform layer (IPL), and peripapillary retinal nerve fiber layer (pRNFL) thicknesses across multiple quadrants as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS).
Benefits of GCL & IPL Measurements
The study examined 120 patients with MS (237 eyes), including 43 with unilateral ON and 26 with bilateral ON.
The researchers observed significant thinning in the GCL and IPL across all quadrants, except the temporal region, among patients with ON. The 3 mm nasal GCL thickness demonstrated the strongest correlation with visual acuity (r=0.725; P<0.001) in the ON group. IPL parameters showed the second strongest correlation, with the 3 mm nasal region showing the highest correlation (r=0.675; P<0.001).
Researchers observed significant thinning in all quadrants of the pRNFL, except the nasal quadrant, among patients with ON; however, this correlation was weaker than that observed with GCL and IPL measurements.
The results indicate that GCL and IPL measurements serve as more reliable and earlier biomarkers for visual prognosis among patients with MS compared with pRNFL, the researchers noted, with the strongest structure-function relationships seen in the 3 mm nasal and inferior quadrants of the ETDRS grid.
Using OCT in Other Demyelinating Disorders
This research follows a study that assessed other demyelinating disorders— neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and double seronegative NMOSD (DN-NMOSD)—using OCT, but with a focus on the impact of comorbidities on disease outcomes for patients with NMOSD, MOGAD, and DN-NMOSD.
That study, published in the European Journal of Neurology, showed patients with AQP4-NMOSD were more likely to have multiple comorbidities compared with patients with MOGAD.
“Importantly, comorbidities in [aquaporin-4 antibody-positive]-NMOSD were more likely to be of autoimmune origin compared to MOGAD or DN-NMOSD. These relationships were independent of age,” the researchers wrote. “In patients with MOGAD or DN-NMOSD and comorbidities, cardiovascular comorbidities and related risk factors were associated with more severe disability and, in patients with AQP4-NMOSD, with a higher annual ON relapse rate.”
In this study, as with the study in patients with MS, the researchers emphasized the role of OCT.
The findings published in BEJ “support the integration of OCT-based GCL and IPL thickness measurements into routine clinical practice for monitoring MS disease progression and treatment efficacy,” the researchers wrote.
In the European Journal of Neurology, the study team noted that future research can examine the mechanisms through which systemic diseases affect retinal structures and enhance the sensitivity of OCT technology in detecting subtle changes, all to address “the overall health and vision preservation needs of these patients.”
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