Optical coherence tomography angiography helps distinguish multiple sclerosis from AQP4‐IgG‐seropositive neuromyelitis optica spectrum disorder

Liu, Chunxin; Xiao, Hui; Zhang, Xiayin; Zhao, Yipeng; Li, Rui; Zhong, Xiaonan; Wang, Yuge; Shu, Yaqing; Chang, Yanyu; Wang, Jingqi; Li, Caixia; Lin, Haotian; Qiu, Wei

doi:10.1002/brb3.2125

Cited by 16 publications

(16 citation statements)

References 51 publications

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“…The study selection process, which is depicted in Fig. 2 , yielded the final inclusion of 18 studies with a total of 1552 evaluated eyes in MS cases (673 MSON eyes, 741 MSNON eyes, and 138 eyes without specification for the presence of ON) in addition to 1107 evaluated control eyes [ 22 , 29 , 31 , 36 , 43 , 45 – 57 ]. Two studies did not report the data on the MS group as a whole, so the data on the MSON group of these studies were used in the MS vs. HC analyses [ 43 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

“…All of the 18 studies had observational designs, five of which were conducted in the United States [ 22 , 46 , 48 , 49 , 57 ], three in Italy [ 31 , 52 , 54 ], three in Turkey [ 45 , 47 , 55 ], one in China [ 29 ], one in Korea [ 50 ], one in Poland [ 43 ], one in Germany [ 56 ], one in Portugal [ 51 ], one in Egypt [ 36 ] and one in Spain [ 53 ]. In regard to MS diagnosis criteria, eight articles used the 2010 revised McDonald Criteria [ 22 , 31 , 45 , 47 , 48 , 53 , 55 , 57 ], eight articles used the 2017 revised McDonald Criteria [ 29 , 36 , 43 , 49 – 51 , 54 , 56 ], a single study used the 2005 revised McDonald Criteria [ 46 ], and finally, one study did not report any specific criteria [ 52 ]. Nine studies selected their case exclusively from the RRMS subtype of patients [ 19 , 36 , 43 , 45 , 47 , 49 , 53 , 54 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

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Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis

Mohammadi

Gouravani

Salehi

et al. 2023

J Neuroinflammation

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Background and objectives Recent literature on multiple sclerosis (MS) demonstrates the growing implementation of optical coherence tomography–angiography (OCT-A) to discover potential qualitative and quantitative changes in the retina and optic nerve. In this review, we analyze OCT-A studies in patients with MS and examine its utility as a surrogate or precursor to changes in central nervous system tissue. Methods PubMed and EMBASE were systematically searched to identify articles that applied OCT-A to evaluate the retinal microvasculature measurements in patients with MS. Quantitative data synthesis was performed on all measurements which were evaluated in at least two unique studies with the same OCT-A devices, software, and study population compared to controls. A fixed-effects or random-effects model was applied for the meta-analysis based on the heterogeneity level. Results The study selection process yielded the inclusion of 18 studies with a total of 1552 evaluated eyes in 673 MS-associated optic neuritis (MSON) eyes, 741 MS without optic neuritis (MSNON eyes), and 138 eyes without specification for the presence of optic neuritis (ON) in addition to 1107 healthy control (HC) eyes. Results indicated that MS cases had significantly decreased whole image superficial capillary plexus (SCP) vessel density when compared to healthy control subjects in the analyses conducted on Optovue and Topcon studies (both P < 0.0001). Likewise, the whole image vessel densities of deep capillary plexus (DCP) and radial peripapillary capillary (RPC) were significantly lower in MS cases compared to HC (all P < 0.05). Regarding optic disc area quadrants, MSON eyes had significantly decreased mean RPC vessel density compared to MSNON eyes in all quadrants except for the inferior (all P < 0.05). Results of the analysis of studies that used prototype Axsun machine revealed that MSON and MSNON eyes both had significantly lower ONH flow index compared to HC (both P < 0.0001). Conclusions This systematic review and meta-analysis of the studies reporting OCT-A measurements of people with MS confirmed the tendency of MS eyes to exhibit reduced vessel density in the macular and optic disc areas, mainly in SCP, DCP, and RPC vessel densities.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis

Mohammadi

Gouravani

Salehi

et al. 2023

J Neuroinflammation

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“…An earlier study suggested that the best OCTA discriminant between NMOSD and MS is the VD reduction pattern, that is, the inferior to nasal (I/N) and I/T ratios for ON eyes and S/T and N/T ratios for non-ON eyes [ 57 ]. The combination of OCT and OCT-A parameters can also potentially differentiate the two conditions, as patients with NMOSD have a significantly lower average thickness of the pRNFL and GC-IPL and significantly smaller whole VD and perfusion density areas than those with MS [ 58 ].…”

Section: Optical Coherence Tomography With Angiography In Multiple Sc...mentioning

confidence: 99%

Optical Coherence Tomography and Optical Coherence Tomography with Angiography in Multiple Sclerosis

et al. 2022

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Multiple sclerosis (MS) is an inflammatory and neurodegenerative, potentially disabling disease of the central nervous system. OCT (Optical Coherence Tomography) and OCT-A (Optical Coherence Tomography with Angiography) are imaging techniques for the retina and choroid that are used in the diagnosis and monitoring of ophthalmological conditions. Their use has recently expanded the study of several autoimmune disorders, including MS. Although their application in MS remains unclear, the results seem promising. This review aimed to provide insight into the most recent OCT and OCT-A findings in MS and may function as a reference point for future research. According to the current literature, the retinal nerve fibre layer (RNFL) and ganglion cell-inner plexiform complex (GC-IPL) are significantly reduced in people with MS and are inversely correlated with disease duration. The use of OCT might help distinguish between MS and neuromyelitis optica spectrum disorders (NMOSD), as the latter presents with more pronounced thinning in both the RNFL and GC-IPL. The OCT-A findings in MS include reduced vessel density in the macula, peripapillary area, or both, and the enlargement of the foveal avascular zone (FAZ) in the setting of optic neuritis. Additionally, OCT-A might be able to detect damage in the very early stages of the disease as well as disease progression in severe cases.

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“…Linear regressions were performed to assess the associations between OCTA measurements of PA and those of HC, with maternal age and gestational age included as covariates. 21…”

Section: Data Analysesmentioning

confidence: 99%

Optical coherence tomography angiography for the characterisation of retinal microvasculature alterations in pregnant patients with anaemia: a nested case‒control study

Wang

et al. 2022

Br J Ophthalmol

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AimsTo characterise retinal microvascular alterations in the eyes of pregnant patients with anaemia (PA) and to compare the alterations with those in healthy controls (HC) using optical coherence tomography angiography (OCTA).MethodsThis nested case‒control study included singleton PA and HC from the Eye Health in Pregnancy Study. Fovea avascular zone (FAZ) metrics, perfusion density (PD) in the superficial capillary plexus, deep capillary plexus and flow deficit (FD) density in the choriocapillaris (CC) were quantified using FIJI software. Linear regressions were conducted to evaluate the differences in OCTA metrics between PA and HC. Subgroup analyses were performed based on comparisons between PA diagnosed in the early or late trimester and HC.ResultsIn total, 99 eyes of 99 PA and 184 eyes of 184 HC were analysed. PA had a significantly reduced FAZ perimeter (βcoefficient=−0.310, p<0.001), area (βcoefficient=−0.121, p=0.001) and increased circularity (βcoefficient=0.037, p<0.001) compared with HC. Furthermore, higher PD in the central (βcoefficient=0.327, p=0.001) and outer (βcoefficient=0.349, p=0.007) regions were observed in PA. PA diagnosed in the first trimester had more extensive central FD (βcoefficient=4.199, p=0.003) in the CC, indicating impaired perfusion in the CC.ConclusionIt was found that anaemia during pregnancy was associated with macular microvascular abnormalities, which differed in PA as pregnancy progressed. The results suggest that quantitative OCTA metrics may be useful for risk evaluation before clinical diagnosis.Trial registration numbers2021KYPJ098 and ChiCTR2100049850.

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Optical coherence tomography angiography helps distinguish multiple sclerosis from AQP4‐IgG‐seropositive neuromyelitis optica spectrum disorder

Cited by 16 publications

References 51 publications

Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis

Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis

Optical Coherence Tomography and Optical Coherence Tomography with Angiography in Multiple Sclerosis

Optical coherence tomography angiography for the characterisation of retinal microvasculature alterations in pregnant patients with anaemia: a nested case‒control study

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