Alterations in the retinal vasculature occur in multiple sclerosis and exhibit novel correlations with disability and visual function measures

Murphy, Olwen C.; Kwakyi, Ohemaa; Iftikhar, Mustafa; Zafar, Sidra; Lambe, Jeffrey; Pellegrini, Nicole; Sotirchos, Elias S.; Gonzalez-Caldito, Natalia; Ogbuokiri, Esther; Filippatou, Angeliki; Risher, Hunter; Cowley, Norah; Feldman, Sydney; Fioravante, Nicholas; Frohman, Elliot M.; Frohman, Teresa C.; Balcer, Laura J.; Prince, Jerry L.; Channa, Roomasa; Calabresi, Peter A.; Saidha, Shiv

doi:10.1177/1352458519845116

Cited by 79 publications

(115 citation statements)

References 39 publications

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“…More precisely, VD decrease remains significant when we remove outliers. Our results support previous research, such as Lanzillo R et al [12] (with Octovue OCTA device) and Olwen C Murphy et al [30] (Spectralis OCTA), both showing a loss of VD in SVP macular ETDRS in MS patients. Only one study evidenced an increase in VD in MS patients [31], which was realized with Angioplex Zeiss device.…”

Section: Discussionsupporting

confidence: 93%

Angiography with optical coherence tomography as a biomarker in multiple sclerosis

et al. 2020

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Purpose To investigate superficial retinal microvascular plexuses detected by optical coherence tomography angiography (OCT-A) in multiple sclerosis (MS) subjects and compare them with healthy controls. Methods A total of 92 eyes from 92 patients with relapsing-remitting MS and 149 control eyes were included in this prospective observational study. OCT-A imaging was performed using Triton Swept-Source OCT (Topcon Corporation, Japan). The vessel density (VD) percentage in the superficial retinal plexus and optic disc area (6 x 6 mm grid) was measured and compared between groups. Results MS patients showed a significant decrease VD in the superior (p = 0.005), nasal (p = 0.029) and inferior (p = 0.040) parafoveal retina compared with healthy subjects. Patients with disease durations of more than 5 years presented lower VD in the superior (p = 0.002), nasal (p = 0.017) and inferior (p = 0.022) parafoveal areas compared with healthy subjects. Patients with past optic neuritis episodes did not show retinal microvasculature alterations, but patients with an EDSS score of less than 3 showed a significant decrease in nasal (p = 0.024) and superior (p = 0.006) perifoveal VD when compared with healthy subjects. Conclusions MS produces a decrease in retinal vascularization density in the superficial plexus of the parafoveal retina. Alterations in retinal vascularization observed in MS patients are independent of the presence of optic nerve inflammation. OCT-A has the ability to detect subclinical vascular changes and is a potential biomarker for diagnosing the presence and progression of MS.

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Section: Discussionsupporting

confidence: 93%

Angiography with optical coherence tomography as a biomarker in multiple sclerosis

et al. 2020

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“…Indeed, in recent reports, vessel density of the SCP and DCP showed variations in both directions (i.e., increased or decreased) ( Table 2 ) [ 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ]. Some authors reported a decreased SCP in both patients with MSON and MSNON [ 92 , 95 , 97 , 98 ]. Conversely, Feucht et al found a decreased SCP and DCP only in eyes with a history of ON.…”

Section: Multiple Sclerosismentioning

confidence: 94%

“…Moreover, parafoveal vascular density was negatively correlated with the EDDS, which is one of the most common used score to assess disability due to MS [ 93 ]. According to these results, Murphy et al, showed that SVD was negatively correlated with both EDDS and multiple sclerosis functional composite scale [ 98 ]. These results highlight the role of retinal vascular density as a possible novel biomarker to monitor MS progression.…”

Section: Multiple Sclerosismentioning

confidence: 99%

Optical Coherence Tomography Angiography in Neurodegenerative Disorders

Pellegrini

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Desideri

et al. 2020

JCM

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Retinal microcirculation shares similar features with cerebral small blood vessels. Thus, the retina may be considered an accessible ‘window’ to detect the microvascular damage occurring in the setting of neurodegenerative disorders. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality providing depth resolved images of blood flow in the retina, choroid, and optic nerve. In this review, we summarize the current literature on the application of OCT-A in glaucoma and central nervous system conditions such as Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Future directions aiming at evaluating whether OCT-A can be an additional biomarker for the early diagnosis and monitoring of neurodegenerative disorders are also discussed.

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“…OCTA may be implemented in several interesting ways to advance the understanding of neuroinflammatory disease. Studies investigating OCTA in neuroinflammatory disease found that its findings are usually highly correlated to measurements of retinal layer thickness performed with the more consolidated technique of OCT (20)(21)(22). Therefore, OCTA can be an alternative quantitative measure of damage to the retina and optic nerve, as atrophied tissue requires less blood supply (20).…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Angiography (OCTA) in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

et al. 2020

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Vascular changes are increasingly recognized as important factors in the pathophysiology of neuroinflammatory disease, especially in multiple sclerosis (MS). The relatively novel technology of optical coherence tomography angiography (OCTA) images the retinal and choroidal vasculature non-invasively and in a depth-resolved manner. OCTA provides an alternative quantitative measure of retinal damage, by measuring vascular density instead of structural atrophy. Preliminary results suggest OCTA is sensitive to retinal damage in early disease stages, while also having less of a “floor-effect” compared with commonly used OCT metrics, meaning it can pick up further damage in a severely atrophied retina in later stages of disease. Furthermore, it may serve as a surrogate marker for vascular pathology in the central nervous system. Data to date consistently reveal lower densities of the retinal microvasculature in both MS and neuromyelitis optica spectrum disorder (NMOSD) compared with healthy controls, even in the absence of prior optic neuritis. Exploring the timing of vascular changes relative to structural atrophy may help answer important questions about the role of hypoperfusion in the pathophysiology of neuroinflammatory disease. Finally, qualitative characteristics of retinal microvasculature may help discriminate between different neuroinflammatory disorders. There are however still issues regarding image quality and development of standardized analysis methods before OCTA can be fully incorporated into clinical practice.

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Alterations in the retinal vasculature occur in multiple sclerosis and exhibit novel correlations with disability and visual function measures

Cited by 79 publications

References 39 publications

Angiography with optical coherence tomography as a biomarker in multiple sclerosis

Angiography with optical coherence tomography as a biomarker in multiple sclerosis

Optical Coherence Tomography Angiography in Neurodegenerative Disorders

Optical Coherence Tomography Angiography (OCTA) in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

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