Abstract
Purpose :
Almost 1 million American adults have multiple sclerosis (MS), a neurodegenerative disease. Retinal nerve fiber layer (RNFL) thinning in MS is established, but there is less data regarding the retinal microvasculature. We used optical coherence tomography (OCT) and OCT angiography (OCTA) to further characterize the retinal and choroidal structure and microvasculature in eyes with MS compared to controls.
Methods :
A prospective cross-sectional comparison of patients with MS and age-, sex-, and race-matched controls with normal cognition. Participants underwent OCT and OCTA imaging using the Zeiss Cirrus HD-5000 Spectral-Domain OCT with AngioPlex. Exclusion criteria included glaucoma, uncontrolled hypertension, visual acuity less than 20/40 on day of imaging, and retinal or optic nerve pathology. Primary outcome measures included OCT parameters: subfoveal choroidal thickness, central subfield thickness, ganglion cell layer-inner plexiform layer (GC-IPL) thickness, and RNFL thickness; and OCTA parameters: superficial capillary plexus foveal avascular zone area (FAZ), 3x3 and 6x6mm macular vessel density (VD) and perfusion density (PD), and 4.5x4.5mm peripapillary capillary perfusion density (CPD) and capillary flux index (CFI). Generalized estimating equations accounting for correlation between 2 eyes of the same patient were performed for statistical analysis.
Results :
We enrolled 27 patients with MS and 27 controls. Patients with MS were matched to their control counterparts with regard to sex (77.8% female in each), age (mean 43.3 years MS, 44.1 control), and race (88.9% White in each). RNFL thickness was lower in MS compared to controls, but not significantly (p=0.06). 3x3mm ETDRS ring PD and 3x3mm ring VD were significantly lower in MS compared to controls (p=0.05, p=0.05). 6x6mm ETDRS circle PD, outer ring PD, circle VD, outer ring VD, inner ring VD were significantly lower in MS compared to controls (p=0.006, p=0.004, p=0.006, p=0.006, p=0.03, respectively). Peripapillary CFI was significantly lower in eyes with MS compared to controls (p=0.03).)
Conclusions :
Patients with MS demonstrated significantly reduced PD, VD, and CFI compared to controls. Retinal and peripapillary microvascular metrics may be helpful as biomarkers for MS diagnosis. More work is needed to elucidate the relationship between these measurements and disease progression.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.