In Vivo OCT Imaging of Müller and Macrophage-Like Cells in the Retinas of Patients with and without MS and related diseases

Abstract

Purpose : Müller cells, associated with Internal Limiting Membrane (ILM) injury, present as hyperreflective dots in the fovea^1-4. Macrophage-like cells (MLCs) respond to injury and inflammation and have a distinct star-shaped morphology^5,6. Both cell types are visible at the vitreoretinal interface via averaged Optical Coherence Tomography (OCT) scans^7-9. MS (Multiple Sclerosis) and MOGAD (Myelin oligodendrocyte glycoprotein antibody-associated disease) feature ocular implications, including retinal ganglion cell atrophy and uveitis^10,11. This study compares MLC and Müller cell density in the macula and peripapillary regions between those with and without these diseases.

Methods : Using the Optovue device, each eye received 10 volumetric OCT scans using two protocols: 3x3mm centered on the macula and 4.5x4.5mm on the optic nerve head. Flattened slabs, segmented from 3-6 μm above the ILM were created from each OCT volume scans. Image J software was used for processing. Structural OCT scans were registered and averaged, signal to noise was increased and cells identified and counted manually using described morphology (Fig.1). Cell counts for each eye were compared between groups for each image region using generalized estimating equation models accounting for within subject correlation (Fig.2).

Results : 16 subjects (15 MS, 1 MOGAD, age 46.87 ± 15.76 years; 87.5% female; 43.75% White, 25% Asian, 12.5% other, 6.25% Black; 68.75% non-Hispanic/Latino) and 5 healthy controls (age 32.5 ± 9.25 years, 100% female, 40% White, 40% Asian; 68.75% non-Hispanic/Latino) were enrolled. MLC density was similar in both maculae and peripapillary regions of MS and control eyes (MS vs. control: macula -0.29/mm²,p=0.71, optic nerve: -1.42/mm² ,(p=0.52). Müller cell density was higher in both maculae and peripapillary regions for MS eyes (MS vs. control: macula 1.27/mm² (95% CI: 0.28, 2.25), p=0.01 optic nerve 0.71/mm² (95% CI: -0.03 to 1.46) p=0.06).

Conclusions : Müller cell densities were higher in the maculas and optic nerves of individuals with MS and MOGAD compared to those without.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Fig.1 Registered and averaged OCT slab 3 µm above ILM.

 

Fig.2 Superficial capillary plexus slab merged with structural OCT slab. Retinas of healthy controls in the left column and of people with MS in the right. MLCs depicted in green and Müller cells in cyan.