OCT angiography shows ability to detect subclinical vascular changes in multiple sclerosis
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OCT angiography could represent a novel and helpful early biomarker for diagnosing and monitoring multiple sclerosis progression, as shown in a study presented at the virtual Euretina congress.
“OCT-A parameters showed retinal vascular abnormalities before the appearance of subsequent neuroaxonal loss,” Daniela Montorio, MD, said.
In 30 eyes of 15 patients, changes in retinal and choriocapillary vessel density were evaluated on OCT-A over 2 years after an initial demyelinating event (IDE), the first neurological symptom of MS referrable to demyelination in the central nervous system.
“A significant reduction of vessel density in the superficial capillary plexus, deep capillary plexus and radial peripapillary capillary plexus was found after 2 years as compared to baseline and 1-year follow-up,” Montorio said.
Vessel density reduction was not associated with ganglion cell complex and retinal nerve fiber layer thickness changes, nor with relapse occurrences and MRI activity changes, she said.
These results demonstrate that, after an IDE, progressive vessel density reduction occurs in the macular and papillary region, in absence of any changes in structural OCT. This would confirm the crucial role of retinal vascular impairment in the early stages of MS.
“It is possible to hypothesize that a single demyelinating and inflammatory event could cause a retinal hypoperfusion that persists over time. This status may initially trigger a vascular compensatory mechanism, which would explain the absence of significant retinal vascular impairment in the first year. During the second year of follow-up, persistent inflammation may lead to vascular decompensation, resulting in significant impairment of retinal perfusion,” Montorio said.
OCT-A has the ability to detect these subclinical vascular changes and confirms to be a useful tool in MS, she said.
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Montorio D. Early retinal and choriocapillary vascular changes in multiple sclerosis: A longitudinal study. Presented at: Euretina congress; Sept. 9-12, 2021 (virtual meeting).
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