Abstract
Purpose:
It has been previously shown that multiple sclerosis (MS) leads to changes in macular morphology due to the loss of the retinal nerve fiber layer (RNFL) and the ganglion cell/inner plexiform layer complex (GCL+IPL). In the present pilot study we assess the changes in the optical properties of the retina in multiple sclerosis (MS).
Methods:
Optical coherence tomography (OCT) examination was performed in twenty-seven patients with MS. The raw macular OCT data were exported and processed using OCTRIMA software. The total reflectance (TR) value of seven intraretinal layers was obtained. The enrolled eyes were analyzed in two groups, the first group had 14 eyes with no history of optic neuritis (ON- group), while the second group had 13 eyes with ON in the history (ON+ group). The TR values of 73 healthy subjects were also used for the comparisons. Total reflectance values were compared using ANOVA with Newman-Keuls post-hoc analysis and ROC curves were built to determine which layer’s TR can discriminate best between ON- and healthy eyes.
Results:
The RNFL and GCL+IPL layers showed a significant decreasing trend in TR (81.41±1.77, 79.76±1.20, 78.67 ± 1.57 and 82.49±2.23, 80.74±1.42 and 80.01±1.39dB for the Healthy, ON- and ON+ groups, respectively), while there were no significant changes observed for the other layers. The RNFL in the ON- group was significantly different compared to both healthy and ON+ groups, while the GCL+IPL was significantly lower only in comparison with the healthy group. When comparing eyes with MS ON- with normal healthy eyes, the highest AUROC values were also observed in the RNFL and GCL+IPL (0.843 and 0.789, respectively). The cutoff point for the RNFL was suggested as 80.151 dB with the sensitivity and specificity at 0.743 and 0.643, respectively. The cutoff point for the GCL+IPL was suggested as 80.887 dB with the sensitivity and specificity at 0.797 and 0.697, respectively.
Conclusions:
The pathological changes of the macula in multiple sclerosis are paralleled by the changes in the optical properties of the ganglion cells and the nerve fibers. This finding may help to further improve the diagnostic capability of OCT in multiple sclerosis.
Keywords: 691 retina: proximal (bipolar, amacrine, and ganglion cells) •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
612 neuro-ophthalmology: diagnosis