Optical coherence tomography angiography findings of multiple sclerosis with or without optic neuritis

Background: Neuromyelitis optica spectrum disorders (NMOSD) are neuroinflammatory diseases of the central nervous system. Patients suffer from recurring relapses and it is unclear whether relapse-independent disease activity occurs and whether this is of clinical relevance. Objective: To detect disease-specific alterations of the retinal vasculature that reflect disease activity during NMOSD. Methods: Cross-sectional analysis of 16 patients with NMOSD, 21 patients with relapsing-remitting multiple sclerosis, and 21 healthy controls using retinal optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), measurement of glial fibrillary acidic protein (GFAP) serum levels, and assessment of visual acuity. Results: Patients with NMOSD but not multiple sclerosis revealed lower foveal thickness (FT) ( p = 0.02) measures and an increase of the foveal avascular zone (FAZ) ( p = 0.02) compared to healthy controls independent to optic neuritis. Reduced FT ( p = 0.01), enlarged FAZ areas ( p = 0.0001), and vessel loss of the superficial vascular complex ( p = 0.01) were linked to higher serum GFAP levels and superficial vessel loss was associated with worse visual performance in patients with NMOSD irrespective of optic neuritis. Conclusion: Subclinical parafoveal retinal vessel loss might occur during NMOSD and might be linked to astrocyte damage and poor visual performance. OCT-A may be a tool to study subclinical disease activity during NMOSD.

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Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study

Journal of Clinical Medicine ◽

10.3390/jcm10040609 ◽

2021 ◽

Vol 10 (4) ◽

pp. 609

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectrum Disorder ◽

Control Group ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary (RPC) vessel density in MS and NMOSD patients using optical coherence tomography angiography (OCTA). A total of 40 MS patients, 13 NMOSD patients, and 20 controls were included. The average RPC vessel density was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS−ON, NMOSD−ON) and in MS+ON, MS−ON, NMOSD+ON, and NMOSD−ON compared with the control group. In NMOSD+ON eyes, the vessel density in superior nasal, nasal superior, and inferior sectors was significantly more decreased than in MS+ON eyes. RPC reduction was also observed in inferior nasal and temporal superior sectors in MS−ON eyes compared with NMOSD−ON eyes. In conclusion, our findings indicate that optic neuritis is associated with a more significant RPC vessel density drop in NMOSD than in MS patients, and the predilection to superior and inferior sectors may be useful as a differential diagnostic marker.

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Optical coherence tomography angiography indicates associations of the retinal vascular network and disease activity in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458517750009 ◽

2018 ◽

Vol 25 (2) ◽

pp. 224-234 ◽

Cited By ~ 40

Author(s):

Nikolaus Feucht ◽

Mathias Maier ◽

Gildas Lepennetier ◽

Moritz Pettenkofer ◽

Carmen Wetzlmair ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Disease Activity ◽

Optical Coherence Tomography Angiography ◽

Retinal Layer ◽

Healthy Controls ◽

Optical Coherence ◽

History Of ◽

Vascular Plexuses

Background: Patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) may show alterations of retinal layer architecture as measured by optical coherence tomography. Little is known about changes in the retinal vascular network during MS. Objective: To characterize retinal vessel structures in patients with MS and CIS and to test for associations with MS disease activity. Method: In all, 42 patients with MS or CIS and 50 healthy controls underwent retinal optical coherence tomography angiography (OCT-A) with analysis of the superficial and deep vascular plexuses and the choriocapillaries. We tested OCT-A parameters for associations with retinal layer volumes, history of optic neuritis (ON), and the retrospective disease activity. Results: Inner retinal layer volumes correlated positively with the density of both the superficial and deep vascular plexuses. Eyes of MS/CIS patients with a history of ON revealed reduced vessel densities of the superficial and deep vascular plexuses as compared to healthy controls. Higher choriocapillary vessel densities were associated with ongoing inflammatory disease activity during 24 months prior to OCT-A examination in MS and CIS patients. Conclusion: Optic neuritis is associated with rarefaction of the superficial and deep retinal vessels. Alterations of the choriocapillaries might be linked to disease activity in MS.

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