Abstract
Purpose :
The role of vasculopathy in multiple sclerosis (MS) remains unclear. Vascular abnormalities may play an important role in the course of the disease. An observational case-control study was made, comparing the macular vascular density in MS patients with and without history of optic neuritis (ON) versus healthy subjects.
Methods :
104 MS eyes and 94 healthy control eyes were included. There were 2 MS subgroups: 10 eyes with history of optic neuritis (MS+ON) and 94 eyes without (MS-ON) optic neuritis. High contrast visual acuity was tested. Ganglion cell layer (GCL), choroidal thickness and the parafoveal vascular network were analyzed.The images were captured by high speed 1050 nm swept-source OCT, and vascular density was analyzed by OCTA ratio analysis (OCTARA), involving 3x3 mm scans with macular centering (measuring 5 sectors: superior, inferior, temporal, nasal and center). Image segmentation was divided into 3 groups: superficial inner vascular plexus, deep vascular plexus and choriocapillaris, based on the OCTA software system.
Results :
There were no significant differences in age, gender or visual acuity (p < 0.01) between the MS group and controls. ON-MS (68±3,95) had better high-contrast visual acuity than ON+MS(59,06±20,60) (p<0.01). GLC in all sectors showed a statistically significant decrease in MS versus the controls. ON+MS presented a decrease in GCL versus ON-MS at supero-nasal and infero-nasal sector (p< 0.01).The superficial vascular plexus was diminished in MS in the superior and center sectors (p<0.01) versus controls.There were no statistically significant differences between ON+MS and ON-MS in the superficial vascular plexus. Choroidal thickness was smaller in MS, with no significant differences between MS+ON and MS-ON. No significant differences in the deep vascular plexus or choriocapillaris were found in any group.
Conclusions :
In comparison with the controls, MS was characterized by thinning of the GCL and a lesser choroidal thickness and superficial vascular plexus density. This latter finding could be attributable in part to diminished metabolic demand secondary to neuronal atrophy. However, while thinning of the GCL was significantly greater in the ON+MS group, neither the superficial vascular plexus nor choroidal thickness showed differences between the presence or absence of ON.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.