Abstract
Purpose :
Recent studies suggested that there are retinal vascular alterations in patients with multiple sclerosis (pMS). The potential relationship between vascular dysfunction and neuroinflammation indicates that a comprehensive understanding of retinal changes using different retinal imaging modalities might help uncover the pathophysiology of MS. This study explored the correlation between retinal vascular changes using multimodal retinal imaging in pMS.
Methods :
The study collected conventional colour fundus (CFI) (Canon) and ultra-widefield (UWFI) (OPTOS California) images, as well as OCT and OCTA scans (Heidelberg Engineering), from 24 controls and 16 pMS. The geometrical features of the retinal vasculature, including vessel calibre, fractal dimension (FD), and width gradient (WG), were extracted for the central and peripheral retina. On CFI, we used Automorph, and on UWFI, we used the VAMPIRE deep learning pipelines. The density of the vascular complexes (VC) and the thickness of the choroid were measured on OCTA and OCT scans using the Heyex software (Heidelberg Engineering). Statistical analysis was done using SPSS with Bonferroni correction.
Results :
36 eyes of 19 controls (Ctr) and 24 eyes of 12 pMS (MSnON:16, MSON:8) were included in the analysis. There was no significant difference in age (Ctrl:46±11 vs MS:48±8, P=0.9) or sex ratios (Female: Ctrl=79% vs MS=54%, P=0.2) between groups. The analysis of the superficial VC on OCTA images showed a lower vessel density in MSON vs Ctrl (-0.032±0.011, p=0.013). Based on the Automorph analyses, we found a decrease in venular calibre (Zone B:-5308.7±1891.4, p=0.005; Zone C:-3388.6 ± 1565.5, p=0.03) and venular FD (Zone C: -0.035 ± 0.01, p=0.002) in MS vs Ctrl. The analysis of UWFI showed an increased arterial WG in the inferior temporal quadrant in MS vs Ctrl (0.54 ± 0.24 μm/mm2, p=0.023).
Conclusions :
Our findings indicate that retinal vascular attenuation is associated with MS and demonstrates the utility of multimodal retinal imaging in pMS. Together with our previous results, we suggest that a better understanding of the ocular manifestations of MS might provide inexpensive, readily available, and well-tolerated markers for MS and may aid the monitoring of the effectiveness of new disease-modifying therapies.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.