Peripapillar Radial Nerve Fiber Layer (RNFL) and Choroidal Macular Thickness (CMT): Valid Biomarkers of Disability Progression during One Year in Patients with Multiple Sclerosis (MS)

Abstract

Aims: Multiple Sclerosis (MS) is an inflammatory disease that shows a great variability in its clinical aspects. This study investigate whether vascular changes (choroidal thickness and macular vascular plexuses) as well as changes in the thickness of retinal nerve fiber layers and retinal ganglion cells occur over one year in patients with MS and if these changes are related with the disability that the patients have. Study Design:  Prospective observational study. Place and Duration of Study: Department of Ophthalmology and Neurology (in Hospital Clínico Universitario de Valencia (Spain). Between January 2016 and September 2017. Methodology: It was analysed 104 eyes of MS patients (divided in groups depending of the type of the MS and their grade of disability measured by the Expanded Disability Status Scale (EDSS) by Kurtzke). Anatomical parameters: RNFL and ganglion cell layer (GCL) were studied using optical coherence tomography (OCT). Vascular parameters were analysed: CMT by OCT and the macular vascular plexuses by OCT-angiography (OCTA). Any subject has an optical neuritis history or other comorbidities. Results: RFNL was thinner in the highest degree of disability group and in patients with primary progressive MS (PPMS). CMT showed a significant decreased in the group that has moderate-severe disability and showed a decrease in the group that their disability worsened during the year of study. Retinal macular plexus showed no difference in any group at one year of study Conclusion: The study of the RFNL and CMT are objective and valuable indicators in these patients, especially with regard to the progression of their disability and with the worst forms of the disease.