Retinal nerve fiber and ganglion cell complex layer thicknesses mirror brain atrophy in patients with relapsing-remitting multiple sclerosis

Abstract

Background: Multiple sclerosis (MS) is associated with progressive brain atrophy, which in turn correlates with disability, depression, and cognitive impairment. Relapsing-remitting multiple sclerosis (RRMS) is a type of MS in which relapses of the disease are followed by remission periods. This is the most common type of the disease. There is a significant need for easy and low-cost methods to these cerebral changes. Changes in retinal layer thickness may reflect alterations in brain white and gray matter volumes. Therefore, this paper aims to determine whether retinal layer thickness, measured using optical coherence tomography (OCT), correlates with volumetric brain assessments obtained by magnetic resonance imaging (MRI). Methods: This retrospective cohort study recruited 53 patients with relapsing–remitting MS who underwent MRI and OCT examinations for evaluation of brain compartment volumes and thickness of retinal layers, respectively. OCT parameters, including central retinal thickness; retinal nerve fiber layer thickness (RNFL, peripapillary thickness); ganglion cell complex thickness (GCC, macular thickness); and Expanded Disability Status Scale (EDSS) results were compared with MRI parameters (cerebral cortex; cerebral cortex and basal ganglia combined; brain hemispheres without the ventricular system; and white matter plaques). We also checked whether there is a correlation between the number of RRMS and OCT parameters. Objective: Our primary objective was to identify whether these patients had retinal thickness changes, and our secondary objective was to check if those changes correlated with the MRI brain anatomical changes. Results: RNFL and GCC thicknesses were strongly (p-value < 0.05) associated with (i) cerebral cortex volume, (ii) combination of brain cortex and basal ganglia volumes, and (iii) the hemispheres but without the ventricular system. White matter plaques (combined) showed only weak or no correlation with RNFL and GCC. There was no correlation between central retinal thickness and brain compartment volumes, and there were weak or no correlations between the summary EDSS scores and OCT results. Conclusions: Retinal layer thickness measured by OCT correlates with select volumetric brain assessments on MRI. During the course of RRMS, the anatomo-pathological structure of the retina might serve as a surrogate marker of brain atrophy and clinical progression within selected domains.

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

“…In fact, in a study by Saidha et al, GC-IPL atrophy mirrored atrophy in the white matter, brainstem, grey matter, thalamus, and the whole brain. However, a recent study by Glasner et al suggested no correlation between white matter plaques and RNFL or GC-IPL thickness [ 17 ]. Nevertheless, grey matter atrophy seems to be the most sensitive marker of progressive MS [ 14 ].…”

Potential ocular indicators to distinguish posterior cortical atrophy and typical Alzheimer’s disease: a cross-section study using optical coherence tomography angiography

“…Therefore, retinal and choroidal examinations have offered a new approach to investigate the development of neurologic diseases in recent decades. A co-atrophy pattern of the entire cerebral volume or a particular brain region and retinal thickness has been reported in the normal aging population [ 6 , 7 ] together with a variety of neurological diseases, including mild cognitive impairment [ 8 ], AD [ 9 , 10 ], Parkinson's disease [ 6 ], and multiple sclerosis [ 11 ] among others.…”

3-Dimensional Immunostaining and Automated Deep-Learning Based Analysis of Nerve Degeneration

“…Even asymptomatic ON lesions, where patients have optic nerve lesions with no history of optic neuritis, are associated with a thinner RNFL and decreased visual contrast sensitivity, and transorbital ultrasonography suggests a decrease in ON diameter in MS patients [ 9 , 10 ]. RNFL and ganglion cell layer degeneration is correlated with decreased brain volume in MS patients, and OCT measurements have been used to monitor effectiveness of therapies in preventing retinal atrophy [ 11 , 12 , 13 , 14 ]. OCT, MRI, level of disability, and visual evoked potentials are all correlated with decreases in low contrast visual sensitivity in MS patients [ 15 ].…”