Optical Coherence Tomography in the Differential Diagnosis of Patients with Multiple Sclerosis and Patients with MRI Nonspecific White Matter Lesions.

Małgorzata Siger,Mariola Świderek-Matysiak,Wojciech Omulecki,Marta Owidzka,Mariusz Stasiołek

doi:10.3390/s21217127

Małgorzata Siger, Mariola Świderek-Matysiak + Show 3 more

Open Access

https://doi.org/10.3390/s21217127

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Journal: Sensors (Basel, Switzerland)	Publication Date: Oct 27, 2021
Citations: 2	License type: CC BY 4.0

Affiliation: Medical University of Lodz

Abstract

In the differential diagnosis of nonspecific white matter lesions (NSWMLs) detected on magnetic resonance imaging (MRI), multiple sclerosis (MS) should be taken into consideration. Optical coherence tomography (OCT) is a promising tool applied in the differential diagnostic process of MS. We tested whether OCT may be useful in distinguishing between MS and NSWMLs patients. In patients with MS (n = 41) and NSWMLs (n = 19), the following OCT parameters were measured: thickness of the peripapillary Retinal Nerve Fibre Layer (pRNFL) in superior, inferior, nasal, and temporal segments; thickness of the ganglion cell-inner plexiform layer (GCIPL); thickness of macular RNFL (mRNFL); and macular volume (MV). In MS patients, GCIPL was significantly lower than in NSWMLs patients (p = 0.024). Additionally, in MS patients, mRNFL was significantly lower than in NSWMLs patients (p = 0.030). The average segmental pRNFL and MV did not differ between MS and NSWMLs patients (p > 0.05). GCIPL and macular RNFL thinning significantly influenced the risk of MS (18.6% [95% CI 2.7%, 25.3%]; 27.4% [95% CI 4.5%, 62.3%]), and reduced GCIPL thickness appeared to be the best predictor of MS. We conclude that OCT may be helpful in the differential diagnosis of MS and NSWMLs patients in real-world settings.

Highlights

Published: 27 October 2021An early introduction of efficient disease-modifying therapy (DMT) in multiple sclerosis (MS) has been shown to be crucial for long-term clinical outcomes [1,2,3]
Analysis of the average and segmental peripapillary Retinal Nerve Fibre Layer (pRNFL) thickness and average macular volume did not show any significant differences between MS and nonspecific white matter lesions (NSWMLs)
A summary of the Optical coherence tomography (OCT) data and statistics is provided in Table 2 and representative OCT and magnetic resonance imaging (MRI) image of MS and NSWMLs patients was provided in Supplementary Material (Figure S2)

Summary

Introduction

Published: 27 October 2021An early introduction of efficient disease-modifying therapy (DMT) in multiple sclerosis (MS) has been shown to be crucial for long-term clinical outcomes [1,2,3]. Substantial effort has been put into the improvement of diagnostic tools and criteria to facilitate the diagnostic process [4,5]. Magnetic resonance imaging (MRI) represents the most important paraclinical tool in the diagnostic process of MS, its specificity is not satisfactory [5]. Focal white matter lesions similar to those observed in MS have been described in many other neurological disorders, such as neuromyelitis optica spectrum disorders (NMOSDs), Sjögren’s syndrome, systemic lupus erythematosus (SLE), Susac syndrome and vasculitis, as well as in patients with migraines, small vessel disease (SVD), and cardiovascular risk factors [10,11]. The constantly increasing availability of MRI results in the frequent detection of incidental, nonspecific white matter lesions (NSWMLs) in patients with otherwise subtle or no clinical symptoms [10].

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