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Objectives: The study aimed to investigate inner retinal changes in multiple sclerosis (MS) patients by comparing them with healthy controls. The study also aimed to assess regional differences of inner retinal layer involvement in eyes with and without optic neuritis (ON). Materials and Methods: This retrospective, cross-sectional study consisted of 141 eyes of 74 relapsing-remitting MS patients and 80 eyes of 40 healthy controls. The study group was separated into two subgroups according to the presence of ON history. Peripapillary retinal nerve fiber layer (pRNFL) thickness, total macular thickness, and thicknesses of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer were compared between the MS and healthy control groups and between eyes with and without ON history. Results: Mean pRNFL, total macular, mRNFL, GCL, and IPL thicknesses were significantly thinner in the MS group than in the control group (p<0.001) and in eyes with ON compared to those without ON (p<0.05). Comparison of inner retinal layer thicknesses in the inner 3-mm ring subfields of the ETDRS grid revealed significant thinning in all subfields of the GCL and IPL of eyes with ON (p<0.05). The inferior subfield demonstrated the highest difference. Conclusion: The study demonstrated that GCL and IPL thinning is a robust and reliable biomarker in all MS patients. The thinning was significantly greater in eyes with ON than in eyes without ON. The study also documented that the inferior region showed significantly greater GCL and IPL thinning in eyes with previous ON attacks.

Purpose The study aimed to investigate the adverse effects of long-term aflibercept injections on the lesion-free retina in eyes with neovascular age-related macular degeneration (nAMD). Methods This retrospective, comparative study consisted of aflibercept-injected 48 eyes diagnosed with nAMD, treatment-naive 42 nAMD eyes, and 40 eyes with drusen in the control group. The measurements were done with spectral-domain optical coherence tomography. The center of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid was centered at a 3-mm distance from the foveola temporally. Total retinal thickness and the thicknesses of each retinal layer in the outer temporal subfield of the ETDRS grid were measured separately. One-way ANOVA test for normally distributed variables was applied for analyses of differences for the comparison of the results between groups. A p-value of less than 0.05 was considered statistically significant. Results The median follow-up time was 51.35 ± 20.92 months. Retinal nerve fiber layer thickness (RNFL) was highest in the treated nAMD group, followed by the treatment-naive nAMD and drusen groups. However, the difference between the treated nAMD and drusen groups showed statistical significance (17.77 ± 2.57 µm; 16.15 ± 1.81 µm, p < 0.05). Total retina, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer, outer nuclear layer, and retina pigment epithelium thicknesses didn’t show a statistically significant difference between the groups (p > 0.05). Conclusions The study demonstrated an increase in RNFL thickness in the lesion-free retina after long-term aflibercept treatments. This finding may suggest the expansion of AMD pathology to the normal-appearing retina rather than the aflibercept effect.