Evaluation of Choroidal Vascular Changes in Patients with Multiple Sclerosis Using Enhanced Depth Imaging Optical Coherence Tomography

Abstract

Objective: To evaluate the choroidal thickness in patients with multiple sclerosis (MS) using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this observational comparative study, 68 eyes of 34 MS patients and 60 eyes of 30 healthy subjects were evaluated. All participants underwent complete ophthalmologic examination and OCT scanning. Choroidal thickness measurements were performed at seven points. Results: The mean subfoveal choroidal thickness was reduced significantly in MS patients (310.71 ± 61.85 μm) versus healthy controls (364.85 ± 41.81 μm) (p < 0.001). The difference was also significant at all six measurement points (p < 0.001 for all). Choroidal thickness measurements revealed no significant difference between MS eyes with a prior optic neuritis (ON) history (MS ON) and those without ON history (MS non-ON). Subfoveal choroidal thickness did not correlate with retinal nerve fiber layer and Expanded Disability Status Scale score, but reduced choroidal thickness was associated with longer disease duration (r = -0.28, p = 0.019) in MS patients. Conclusion: In MS patients, choroidal structural changes occur both in MS ON and MS non-ON eyes. The decreased choroidal thickness might provide evidence to support a potential role of vascular dysregulation in the pathophysiology of MS.

Comment on the Paper by Esen et al. Entitled ´Evaluation of Choroidal Vascular Changes in Patients with Multiple Sclerosis Using Enhanced Depth Imaging Optical Coherence Tomography´

“…They suggested that RNFL can be used as a marker of white matter damage in MS. Chatziralli et al [3] evaluated RNFL thickness in optic neuritis associated with MS. Similar to Esen et al [1], they found a reduced average-RNFL thickness in MS eyes with optic neuritis. However, they also reported that inferior- and temporal-quadrant RNFL thickness is different between eyes with optic neuritis and control eyes.…”

“…We read the article by Esen et al [1] entitled ‘Evaluation of choroidal vascular changes in patients with multiple sclerosis using enhanced depth imaging optical coherence tomography' with great interest. The authors evaluated the choroidal thickness changes in patients with multiple sclerosis (MS) using optical coherence tomography.…”

“…Moreover, they found a statistically significant difference in the inferior quadrant between eyes without optic neuritis and control eyes [3]. Esen et al [1] only reported the difference between the average-RNFL thicknesses of the groups but they did not compare the quadrants in their study. As Scheel et al [2], we think that RNFL can be used as a marker of MS damage in the optic pathway and white matter and wonder whether there is a significant difference between the control, MS-with-optic-neuritis and MS-without-optic-neuritis groups in their study.…”

Comment on Evaluation of Choroidal Vascular Changes in Patients with Multiple Sclerosis Using Enhanced Depth Imaging Optical Coherence Tomography

“…It has been shown in the literature that age, sex, diurnal variation, systemic/local diseases and their treatment, intraocular pressure, and many other factors have effect on CT [2,3]. Although Esen et al [1] have specified many factors in their study, we would like to address some points, which may also be important to consider.…”

“…We have read and reviewed the article by Esen et al [1 ]entitled ‘Evaluation of choroidal vascular changes in patients with multiple sclerosis using enhanced depth imaging optical coherence tomography' with great interest. The authors examined the choroidal thickness (CT) in 68 eyes of 34 multiple sclerosis (MS) patients by using enhanced depth imaging optical coherence tomography.…”