Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Apr;30(4):1025-1034.
doi: 10.1111/ene.15718. Epub 2023 Feb 16.

Retinal layer thickness predicts disability accumulation in early relapsing multiple sclerosis

Gabriel Bsteh  1 , Harald Hegen  2 , Patrick Altmann  1 , Michael Auer  2 , Klaus Berek  2 , Franziska Di Pauli  2 , Lukas Haider  3 , Barbara Kornek  1 , Nik Krajnc  1 , Fritz Leutmezer  1 , Stefan Macher  1 , Paulus Rommer  1 , Lisa-Maria Walchhofer  4 , Karin Zebenholzer  1 , Gudrun Zulehner  1 , Florian Deisenhammer  2 , Berthold Pemp  5 , Thomas Berger  1
Affiliations
Observational Study

Retinal layer thickness predicts disability accumulation in early relapsing multiple sclerosis

Gabriel Bsteh et al. Eur J Neurol. 2023 Apr.

Abstract

Background and purpose: This study was undertaken to investigate baseline peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell and inner plexiform layer (GCIPL) thickness for prediction of disability accumulation in early relapsing multiple sclerosis (RMS).

Methods: From a prospective observational study, we included patients with newly diagnosed RMS and obtained spectral-domain optical coherence tomography scan within 90 days after RMS diagnosis. Impact of pRNFL and GCIPL thickness for prediction of disability accumulation (confirmed Expanded Disability Status Scale [EDSS] score ≥ 3.0) was tested by multivariate (adjusted hazard ratio [HR] with 95% confidence interval [CI]) Cox regression models.

Results: We analyzed 231 MS patients (mean age = 30.3 years, SD = 8.1, 74% female) during a median observation period of 61 months (range = 12-93). Mean pRNFL thickness was 92.6 μm (SD = 12.1), and mean GCIPL thickness was 81.4 μm (SD = 11.8). EDSS ≥ 3 was reached by 28 patients (12.1%) after a median 49 months (range = 9-92). EDSS ≥ 3 was predicted with GCIPL < 77 μm (HR = 2.7, 95% CI = 1.6-4.2, p < 0.001) and pRNFL thickness ≤ 88 μm (HR = 2.0, 95% CI = 1.4-3.3, p < 0.001). Higher age (HR = 1.4 per 10 years, p < 0.001), incomplete remission of first clinical attack (HR = 2.2, p < 0.001), ≥10 magnetic resonance imaging (MRI) lesions (HR = 2.0, p < 0.001), and infratentorial MRI lesions (HR = 1.9, p < 0.001) were associated with increased risk of disability accumulation, whereas highly effective disease-modifying treatment was protective (HR = 0.6, p < 0.001). Type of first clinical attack and presence of oligoclonal bands were not significantly associated.

Conclusions: Retinal layer thickness (GCIPL more than pRNFL) is a useful predictor of future disability accumulation in RMS, independently adding to established markers.

Keywords: biomarker; disability; multiple sclerosis; optical coherence tomography; predictor; retina.

PubMed Disclaimer

References

REFERENCES

    1. Compston A, Coles A. Multiple sclerosis. Lancet. 2002;359(9313):1221-1231.
    1. Giovannoni G. Disease-modifying treatments for early and advanced multiple sclerosis. Curr Opin Neurol. 2018;31(3):1-11.
    1. Cree BAC, Mares J, Hartung H-P. Current therapeutic landscape in multiple sclerosis. Curr Opin Neurol. 2019;32(3):365-377.
    1. Bsteh G, Hegen H, Teuchner B, et al. Peripapillary retinal nerve fibre layer as measured by optical coherence tomography is a prognostic biomarker not only for physical but also for cognitive disability progression in multiple sclerosis. Mult Scler J. 2017;25(2):1352458517740216.
    1. Bsteh G, Berek K, Hegen H, et al. Macular ganglion cell-inner plexiform layer thinning as a biomarker of disability progression in relapsing multiple sclerosis [Internet]. Mult Scler J. 2020;27(5):1352458520935724.

Publication types

LinkOut - more resources