Filippatou Angeliki, Theodorou Aikaterini, Stefanou Maria-Ioanna, Tzanetakos Dimitrios, Kitsos Dimitrios, Moschovos Christos, Koutsouraki Effrosyni, Tzartos John S, Giannopoulos Sotirios, Voumvourakis Konstantinos, Tsivgoulis Georgios
Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
J Neurol Sci. 2025 Mar 15;470:123422. doi: 10.1016/j.jns.2025.123422. Epub 2025 Feb 11.
Anterior visual pathway involvement is common in multiple sclerosis (MS) and optical coherence tomography (OCT) can be utilized to examine the integrity of the ganglion cell axons (peri-papillary retinal nerve fiber layer; pRNFL) and cell bodies (ganglion cell & inner plexiform layer; GCIPL). OCT angiography (OCTA) can be used to investigate the retinal microvasculature. In this systematic review and meta-analysis, we synthesized OCT and OCTA findings in MS.
We identified studies that performed OCT and OCTA in people with MS and included data permitting at least one of the following comparisons: 1) MS optic neuritis (MS-ON) vs healthy-control (HC) eyes; 2) MS non-ON (MS-NON) vs HC eyes; and 3) MS-ON vs MS-NON eyes.
The OCT meta-analysis included 170 studies and 8542 HC, 5529 MS-ON, and 14,822 MS-NON eyes. MS-ON and MS-NON eyes had lower pRNFL and GCIPL thickness compared to HC. There was no difference in inner nuclear layer (INL) thickness between HC and MS; INL was thicker in MS-ON compared to MS-NON eyes. The OCTA meta-analysis included 24 studies and 1344 HC, 505 MS-ON, and 1168 MS-NON eyes. MS-ON and MS-NON eyes had lower peripapillary vessel density and macular superficial vessel density compared to HC. We also summarized 12 studies evaluating the diagnostic yield of inter-eye differences in OCT measurements for detecting unilateral optic nerve involvement.
OCT allows for reliable quantification of retinal neuro-axonal damage in MS. In our review, we highlight studies demonstrating that OCT can establish robust thresholds for detecting unilateral optic nerve involvement.
前部视觉通路受累在多发性硬化症（MS）中很常见，光学相干断层扫描（OCT）可用于检查神经节细胞轴突（视乳头周围视网膜神经纤维层；pRNFL）和细胞体（神经节细胞和内网状层；GCIPL）的完整性。OCT血管造影（OCTA）可用于研究视网膜微血管系统。在这项系统评价和荟萃分析中，我们综合了MS患者的OCT和OCTA检查结果。
我们检索了对MS患者进行OCT和OCTA检查的研究，并纳入了允许进行以下至少一项比较的数据：1）MS视神经炎（MS-ON）与健康对照（HC）眼；2）MS非视神经炎（MS-NON）与HC眼；3）MS-ON与MS-NON眼。
OCT荟萃分析纳入了170项研究，涉及8542只HC眼、5529只MS-ON眼和14822只MS-NON眼。与HC相比，MS-ON和MS-NON眼的pRNFL和GCIPL厚度更低。HC与MS的内核层（INL）厚度无差异；与MS-NON眼相比，MS-ON的INL更厚。OCTA荟萃分析纳入了24项研究，涉及1344只HC眼、505只MS-ON眼和1168只MS-NON眼。与HC相比，MS-ON和MS-NON眼的视乳头周围血管密度和黄斑浅表血管密度更低。我们还总结了12项评估OCT测量中眼间差异对检测单侧视神经受累的诊断价值的研究。
OCT能够可靠地量化MS患者视网膜神经轴突损伤。在我们的综述中，我们重点介绍了一些研究，这些研究表明OCT可以建立用于检测单侧视神经受累的可靠阈值。
