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OCT-based retina assessment reflects visual impairment in multiple sclerosis

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Item Type:Article
Title:OCT-based retina assessment reflects visual impairment in multiple sclerosis
Creators Name:Stolowy, N., Gutmann, L., Lüpke, M., David, T., Dorr, M., Mayer, C., Heesen, C., Oertel, F.C., Lin, T.Y., Paul, F., Zimmermann, H.G. and Stellmann, J.P.
Abstract:PURPOSE: To explore the relationship between visual performance and retinal morphology as assessed by optical coherence tomography (OCT), and the ability of OCT to reflect visual impairment in people with multiple sclerosis (PwMS) compared with healthy controls (HC). METHODS: We gathered data from two neurology referral centers on PwMS and HC. Neurological and ophthalmological assessments, including OCT, high-contrast visual acuity (HCVA) and low-contrast visual acuity (LCVA), area under the log contrast sensitivity function (AULCSF), and vision-related quality of life (National Eye Institute Visual Function Questionnaire), were conducted between 2018 and 2020, with follow-up at 1 year. RESULTS: A total of 137 PwMS (271 eyes) and 118 HC (236 eyes) were available for analysis. The peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell layer and inner plexiform layer volume (mGCIPL) volume were both reduced in PwMS (92 µm in PwMS vs 98 µm in HC [P < 0.001], 0.55 mm3 vs 0.62 mm3 [P < 0.001], respectively). A cutoff effect for visual impairment was observed in PwMS when pRNFL fell below 68.8 µm (HCVA), 71.4 µm (LCVA), and 72.6 µm (AULCSF). Using mixed effects models, the mGCIPL volume emerged as the variable most strongly associated with the AULCSF (P < 0.001). The AULCSF showed the strongest correlation with both pRNFL and mGCIPL (P < 0.001), with optic neuritis being a significant contributing factor (P < 0.001). CONCLUSIONS: AULCSF outperformed standard HCVA and LCVA, closely reflecting retinal atrophy. mGCIPL loss showed stronger associations with vision tests and detected neurodegeneration without the cutoff effect seen in pRNFL, making it the best marker for neuronal atrophy.
Keywords:Contrast Sensitivity, Follow-Up Studies, Multiple Sclerosis, Nerve Fibers, Optical Coherence Tomography, Quality of Life, Retina, Retinal Ganglion Cells, Vision Disorders, Visual Acuity
Source:Investigative Ophthalmology & Visual Science
ISSN:0146-0404
Publisher:Association for Research in Vision and Ophthalmology
Volume:66
Number:2
Page Range:39
Date:February 2025
Official Publication:https://doi.org/10.1167/iovs.66.2.39
PubMed:View item in PubMed

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