Retina hypoperfusion in multiple sclerosis: Is it only a consequence of atrophy?

Abstract

Aims/Purpose: To study if there are vascular changes in patients with multiple sclerosis (MS) when compared healthy controls, analysing oct and OCT‐angiography findings (choroidal thickness and retinal vascular density) at the macular level.Methods: The study compared two groups (controls and patients) and it analysed whether there were statistically significant differences in the different parameters studied using OCT: choroidal thickness and in the vascular macular plexuses, using OCT‐angiography. Any patient has an optic neuritis history. It was also studied whether there was a statistically significant correlation between anatomical parameters (radial nerve fibre layer, RNFL and ganglion cell layer, GCL) and vascular parameters matching cases and controls by age and sex.Results: We found a statistically significant reduction in macular choroidal thickness in patients when compared to controls. The study of retinal vascular plexuses showed that the superficial and deep retinal vascular plexuses and the choriocapillaris plexus showed significantly lower vascular density in the patients group. Variations in anatomical parameters between anatomical parameters and in vascular parameters between vascular parameters pairing cases and controls show direct correlations. Regarding the correlation between the differences in anatomical versus vascular parameters, we only observed a low direct correlation between the difference in the papillary RFNL and that of the superficial macular vascular plexus between case and control group.Conclusions: The density of macular vascular plexus and choroidal thickness proved to be significantly lower in MS patients than in healthy subjects. To date, it is not known to what extent hypoperfusion in MS is a cause or consequence of the brain disease or whether it is a simply association. Vascular parameters could be used as useful markers in the diagnosis and follow‐up of MS.