Retinal Nerve Fiber Layer Thickness and Total Macular Volume in Multiple Sclerosis Subtypes and Their Relationship with Severity of Disease, a Cross-Sectional Study
Received 4 September 2019
Accepted for publication 25 December 2019
Published 17 January 2020 Volume 2020:12 Pages 15—23
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Margaret Wong-Riley
Fatemeh Eslami, 1 Masoud Ghiasian, 2 Elham Khanlarzade, 3 Ehsan Moradi 4
1Department of Ophthalmology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 2Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 3Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 4School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
Correspondence: Fatemeh Eslami
Background: Optic neuritis (ON) is an inflammatory demyelinating lesion in the optic nerve, which is strongly associated with multiple sclerosis (MS). Optical coherence tomography (OCT) is a noninvasive technique for the evaluation of the retinal layers. Our aim was to examine OCT metrics including retinal nerve fiber layer thickness (RNFLT), and total macular volume (TMV), in MS subtypes and their relationship with duration, first manifestation, and severity of disease.
Material and Methods: In this cross-sectional study, patients with a definite diagnosis of MS underwent complete ophthalmic and neurologic examination. OCT parameters including TMV and RNFLT were compared between MS subtypes and different first manifestations of MS. Their relationships were also studied with the duration and severity of disease based on the Expanded Disability Status Scale (EDSS) score.
Results: A total of 240 eyes were examined in 120 enrolled MS patients. The differences in RNFLT were not analytically meaningful between the subtypes of MS, but the differences in TMV values were statistically significant between the subtypes of MS (P: 0.39 and P: 0.04, respectively). The differences between RNFLT and TMV of eyes with and without ON were statistically significant between these two groups (P< 0.001 and P< 0.001). There was also an inverse correlation between EDSS disability score and RNFLT and TMV values (P: 0.00, r: − 0.33 and P: 0.034, r: − 0.11, respectively) and a significant inverse correlation between the duration of MS and RNFLT (P: 0.00, r: − 0.47). The differences in RNFLT and TMV values were analytically meaningful between the categories of first manifestations of MS (P: 0.000 and P: 0.027, respectively).
Conclusion: RNFLT and TMV represent noninvasive parameters for assessment of neuroaxonal degeneration in the anterior visual pathway that correlate with the severity and duration of multiple sclerosis. The lowest RNFLT and TMV values were also seen in the perceptual category between the first manifestations of MS. Therefore, they may be useful in the evaluation of MS patients.
Keywords: multiple sclerosis, optical coherence tomography, retinal nerve fiber layer thickness, total macular volume
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