Neuro‐retinal changes evaluation in multiple sclerosis patients: 10 years follow‐up

Abstract

PurposeTo analyze functional and structural changes in the retina and optic nerve (ON) in patients with multiple sclerosis (MS) compared to healthy controls (C) and after 10 years of follow‐up.MethodsFifty eyes of patients with mild‐moderate MS were evaluated and compared to 50 eyes of C at a baseline visit and at 10 years of follow‐up. The following functional parameters were evaluated: best‐corrected visual acuity (BCVA), color vision examined with the Ishihara test, and mean deviation of visual field (VF) analyzed using the Humphrey perimetry. The structural parameters of the ON were also studied using the NSITE axonal application of the optical coherence tomograph (OCT) Heidelberg Spectralis.ResultsNo differences were found in the functional parameters in MS patients compared to C, neither at 10 years of follow‐up (p > 0.05). However a statistically significant decrease was observed in the structural parameters between C and MS patients at 10 years of follow‐up: mean, nasal‐inferior (NI), temporal‐inferior (TI), temporal (T), temporal‐superior (TS), papillomacular bundle and nasal/temporal (N/T) ratio thickness (p < 0.001), but also in the axonal thickness, specifically in the mean, TI, T, TS, papillomacular bundle and N/T ratio thickness (p < 0.001) measured with OCT in patients with MS after 10 years of disease progression. A higher functional disability using the Expanded Disability Status Scale was also recorded.ConclusionsAxonal damage can be analyzed and quantified in the retina and ON using the OCT in MS. Patients with MS showed significant decrease in the retina nerve fiber layer at 10 years of follow–up compared to C and a progressive axonal death (without outbreaks) that could be detected and quantified using the OCT, but not with the functional tests (BCVA, color and VF).