Zahavi Ori, Nilsson Maria, Manouchehrinia Ali, Brautaset Rune, Kockum Ingrid, Venkataraman Abinaya P, Dominguez-Vicent Alberto
Unit of Optometry, Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Front Neurol. 2025 Mar 31;16:1549091. doi: 10.3389/fneur.2025.1549091. eCollection 2025.
To evaluate the structural changes of individual inner retinal layers in the macular area and identify the most affected layer in subgroups of multiple sclerosis (MS) patients compared to healthy controls (HC).
In total, Optical coherence tomography (OCT) data from 507 MS patients and 183 HC were exported retrospectively. The MS patients were grouped according to MS sub-types, primary progressive (PP), Relapsing-Remitting (RR) and Secondary progressive (SP). Thickness of four inner retinal layers, the macula nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL) and the inner nuclear layer (INL) were evaluated in nine sectors based on the Early Treatment Diabetic Retinopathy Study (ETDRS) map. The individual layer thickness measurements were compared between each MS subtype and HC while controlling for the potential confounding effects of age, sex, and previous history of ON.
The NFL was thinner in all inferior, superior, and nasal sectors in all MS subgroups. The thinning was more pronounced in the PP and SP groups. The thinning varied between 3 to 20% compared to HC. The GCL was also thinner, especially in the inner sectors of the ETDRS grid. The SP subgroup had the largest reduction (27.8%) in the inner nasal sector. The IPL was also reduced in all MS subgroups. In contrast to PP and SP groups, the RR group showed an increased INL thickness compared to HC in the inner sectors.
Macular region is suitable for monitoring the neurodegeneration in MS. The macular NFL seems to have the strongest association with MS disease and may serve as a marker for global atrophy. The pattern of IPL reduction tends to follow the GCL, so these layers can be measured combined.
评估黄斑区单个视网膜内层的结构变化，并确定与健康对照（HC）相比，多发性硬化症（MS）患者亚组中受影响最严重的层。
回顾性导出507例MS患者和183例HC的光学相干断层扫描（OCT）数据。MS患者根据MS亚型进行分组，即原发性进展型（PP）、复发缓解型（RR）和继发性进展型（SP）。基于早期糖尿病视网膜病变研究（ETDRS）地图，在九个扇形区域评估四个视网膜内层的厚度，即黄斑神经纤维层（NFL）、神经节细胞层（GCL）、内网状层（IPL）和内核层（INL）。在控制年龄、性别和既往视神经炎病史等潜在混杂因素的同时，比较各MS亚型与HC之间的各层厚度测量值。
所有MS亚组的所有下方、上方和鼻侧扇形区域的NFL均变薄。在PP组和SP组中变薄更为明显。与HC相比，变薄幅度在3%至20%之间。GCL也变薄，尤其是在ETDRS网格的内侧扇形区域。SP亚组在内鼻侧扇形区域的减少幅度最大（27.8%）。所有MS亚组的IPL也减少。与PP组和SP组不同，RR组在内侧扇形区域与HC相比，INL厚度增加。
黄斑区适用于监测MS中的神经退行性变。黄斑NFL似乎与MS疾病的关联最强，可作为整体萎缩的标志物。IPL减少的模式倾向于与GCL一致，因此可以联合测量这些层。
