OCT measures linked to neurodegeneration, disability in patients with MS
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Key takeaways:
- OCT measures were positively associated with total brain and gray matter volumes but not white matter volume.
- OCT is a valuable tool in assessing changes related to physical and cognitive disability.
Peripapillary retinal nerve fiber layer thickness and ganglion cell/inner plexiform layer volume are key OCT markers of neurodegeneration and disability in patients with multiple sclerosis, according to data in the Journal of Neurology.
“Previous studies showed consistent associations of OCT measures with white matter lesion load and total brain volume loss,” Alessandro Cagol, MD, from the University of Basel in Switzerland, and colleagues wrote. “However, investigations on the relationship of OCT measures with the volumes of gray matter and white matter, as well as with volumes of regional brain structures relevant in MS pathology, produced contradictory results.”
In a cross-sectional study, 95 patients with MS and 52 healthy controls underwent OCT and MRI examinations to determine mean peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell/inner plexiform layer (GCIPL) volume.
Cagol and colleagues reported that patients with MS had significantly lower pRNFL thickness (P <.0001) and GCIPL volume (P < .0001) compared with healthy controls, but there were no significant differences in retinal inner nuclear layer volume (P = .06) between groups.
Results also showed that patients with MS had lower total brain volume, including lower total gray and white matter volumes vs. healthy controls (P < .0001 for all).
Further, researchers reported a positive correlation between pRNFL and GCIPL and total brain volume (P = .002 and P = .04, respectively), as well as total gray matter volume (P = .001 and P = .002, respectively), but not total white matter volume.
“We showed that OCT measures of retinal neuroaxonal loss (pRNFL and GCIPL) reflect the accumulation of [gray matter] loss in [patients with MS], independently of lesion load in the whole brain and in the [optic radiations],” Cagol and colleagues wrote. “The overlap between the brain regions associated with retinal atrophy and those associated with physical and cognitive disability underlines the clinical relevance of OCT measures, and highlights the role of pRNFL and GCIPL as markers of neurodegeneration and disability in MS.”
Perspective
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OCT can be a powerful tool in the evaluation of brain health, particularly in the detection of neuroaxonal loss and neurodegeneration as it pertains to MS-related damage of the central nervous system. There is valuable information to be obtained from OCT scans. However, to form a comprehensive understanding of the patient’s disease, practitioners should use these test results in conjunction with other clinical and imaging assessments.
Overall, OCT allows for a noninvasive and time-efficient approach to evaluating gray matter damage and could be used to monitor progression of disease. This tool could be especially useful for early detection, as it can lead to early diagnosis and treatment, thereby improving the patient journey and overall quality of life. Optometrists should continue to collaborate with neurologists to explore the full potential of OCT in the management of patients with MS.
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