Assessment of Retinal Nerve Fiber Layer (RNFL) and Retinal Ganglion Cell Layer (RGCL) Thickness in Radiologically Isolated Syndrome (RIS)

Background: Three-thirds of people with radiologically isolated syndrome (RIS) develop multiple sclerosis (MS) within five years following their first brain magnetic resonance imaging (MRI). Subclinical applications of optical coherence tomography (OCT) include measuring the thickness of different retinal layers and monitoring the progression of visual pathway atrophy and neurodegeneration in relation to the progress of the entire brain. Objectives: Our OCT study was conducted in individuals with RIS to evaluate the thickness of the macular retinal nerve fiber layer (mRNFL) and the retinal ganglion cell layer (RGCL). Methods: In this study, 22 patients with RIS and 23 healthy individuals healthy control (HC) were enrolled. The control group and the RIS subjects underwent retinal imaging with OCT. Results: Total mRNFL thickness was 110.34 ± 13.71 μm in the RIS patients and 112.10 ± 11.23 μm in the HC group. Regional analysis of the mRNFL showed that the difference in thickness was more prominent in the superior quadrant. In regards to ganglion cell layer (GCL)++ thickness, the RIS and HCs population showed statistically significant differences in the nasal (P = 0.041), inferior (P = 0.040), and superior (P = 0.045) quadrants. The nasal (P = 0.041) quadrant showed the highest reduction in thickness compared to other regions of the GCL++. Meanwhile, no significant reduction was seen in GCL+ thickness (P-value > 0.05). When the thickness of the retinal layer of the right eye was compared to that of the left eye of the RIS group, no statistically significant differences were found (P-value > 0.05). Conclusions: Compared to the control group, the RIS group had a lower mean thickness of mRNFL and GCL++, indicating retinal neuroaxonal loss.

[1]  A. Uccelli,et al.  Choroidal Thickness in Multiple Sclerosis: An Optical Coherence Tomography Study , 2022, Journal of clinical neurology.

[2]  A. Pérez Del Palomar,et al.  Comparison of Machine Learning Methods Using Spectralis OCT for Diagnosis and Disability Progression Prognosis in Multiple Sclerosis , 2022, Annals of Biomedical Engineering.

[3]  S. Saidha,et al.  OCT retinal nerve fiber layer thickness differentiates acute optic neuritis from MOG antibody-associated disease and Multiple Sclerosis: RNFL thickening in acute optic neuritis from MOGAD vs MS. , 2022, Multiple sclerosis and related disorders.

[4]  V. Shaygannejad,et al.  Prevalence of multiple sclerosis (MS) in Iran: a systematic review and meta-analysis , 2021, Neurological Sciences.

[5]  R. Benedict,et al.  Visual deficits and cognitive assessment of multiple sclerosis: confounder, correlate, or both? , 2021, Journal of Neurology.

[6]  L. Vuong,et al.  Recent advances and future directions on the use of optical coherence tomography in neuro-ophthalmology , 2021, Taiwan journal of ophthalmology.

[7]  M. Mühlau,et al.  Inner retinal layer thinning in radiologically isolated syndrome predicts conversion to multiple sclerosis , 2020, European journal of neurology.

[8]  P. Lundberg,et al.  Retinal thinning and brain atrophy in early MS and CIS , 2020, Acta neurologica Scandinavica.

[9]  E. Karabulut,et al.  Retinal degeneration is associated with brain volume reduction and prognosis in radiologically isolated syndrome , 2018, Multiple sclerosis.

[10]  Jerry L Prince,et al.  Spinal cord and infratentorial lesions in radiologically isolated syndrome are associated with decreased retinal ganglion cell/inner plexiform layer thickness , 2018, Multiple sclerosis.

[11]  D. Okuda Radiologically isolated syndrome should be treated with disease-modifying therapy – Yes , 2017, Multiple sclerosis.

[12]  Bernhard Hemmer,et al.  Optical coherence tomography indicates disease activity prior to clinical onset of central nervous system demyelination , 2016, Multiple sclerosis.

[13]  M. Sormani,et al.  Primary Progressive Multiple Sclerosis Evolving From Radiologically Isolated Syndrome , 2015, Annals of neurology.

[14]  P. Aspelin,et al.  Radiologically isolated syndrome – incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review , 2013, Multiple sclerosis.

[15]  G. Comi,et al.  Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. , 1997, Brain : a journal of neurology.