Open AccessOptical coherence tomography in multiple sclerosis: A 3‐year prospective multicenter study
Author(s) -
Paul Friedemann,
Calabresi Peter A.,
Barkhof Frederik,
Green Ari J.,
Kardon Randy,
SastreGarriga Jaume,
Schippling Sven,
Vermersch Patrick,
Saidha Shiv,
Gerendas Bianca S.,
SchmidtErfurth Ursula,
Agoropoulou Catherine,
Zhang Ying,
Seifer Gustavo,
Petzold Axel
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51473
Subject(s) - medicine , multiple sclerosis , nerve fiber layer , expanded disability status scale , retinal , optic neuritis , inner plexiform layer , atrophy , ophthalmology , ganglion , intraclass correlation , pathology , anatomy , clinical psychology , psychiatry , psychometrics
Abstract Objective To evaluate changes over 3 years in the thickness of inner retinal layers including the peripapillary retinal nerve fiber layer (pRNFL), and combined macular ganglion cell and inner plexiform layers (mGCIPL), in individuals with relapsing‐remitting multiple sclerosis (RRMS) versus healthy controls; to determine whether optical coherence tomography (OCT) is sufficiently sensitive and reproducible to detect small degrees of neuroaxonal loss over time that correlate with changes in brain volume and disability progression as measured by the Expanded Disability Status Scale (EDSS). Methods Individuals with RRMS from 28 centers ( n = 333) were matched with 64 healthy participants. OCT scans were performed on Heidelberg Spectralis machines (at baseline; 1 month; 6 months; 6‐monthly thereafter). Results OCT measurements were highly reproducible between baseline and 1 month (intraclass correlation coefficient >0.98). Significant inner retinal layer thinning was observed in individuals with multiple sclerosis (MS) compared with controls regardless of previous MS‐associated optic neuritis––group differences (95% CI) over 3 years: pRNFL: −1.86 (−2.54, −1.17) µ m; mGCIPL: −2.03 (−2.78, −1.28) µ m (both p < 0.0001; effect sizes 0.39 and 0.34). Greater inner retinal layer atrophy was observed in individuals diagnosed with RRMS <3 years versus >5 years (pRNFL: p < 0.05; mGCIPL: p < 0.01). Brain volume decreased by 1.3% in individuals with MS over 3 years compared to 0.5% in control subjects (effect size 0.76). mGCIPL atrophy correlated with brain atrophy ( p < 0.0001). There was no correlation of OCT data with disability progression. Interpretation OCT has potential to estimate rates of neurodegeneration in the retina and brain. The effect size for OCT, smaller than for magnetic resonance imaging based on Heidelberg Spectralis data acquired in this study, was increased in early disease.