Retinal ganglion cell loss is associated with future disability worsening in early relapsing-remitting multiple sclerosis

Wauschkuhn, Josephine; Buenrostro, Gilberto Solorza; Aly, Lilian; Asseyer, Susanna; Wicklein, Rebecca; Hartberger, Julia Maria; Ruprecht, Klemens; Muehlau, Mark; Schmitz-Huebsch, Tanja; Chien, Claudia; Berthele, Achim; Brandt, Alexander U. U.; Korn, Thomas; Paul, Friedemann; Hemmer, Bernhard; Zimmermann, Hanna G. G. and Knier, Benjamin (2023): Retinal ganglion cell loss is associated with future disability worsening in early relapsing-remitting multiple sclerosis. In: European Journal of Neurology, Vol. 30, No. 4: pp. 982-990

Abstract

Background and purpose: Thinning of the retinal combined ganglion cell and inner plexiform layer (GCIP) as measured by optical coherence tomography (OCT) is a common finding in patients with multiple sclerosis. This study aimed to investigate whether a single retinal OCT analysis allows prediction of future disease activity after a first demyelinating event.Methods: This observational cohort study included 201 patients with recently diagnosed clinically isolated syndrome or relapsing- remitting multiple sclerosis from two German tertiary referral centers. Individuals underwent neurological examination, magnetic resonance imaging, and OCT at baseline and at yearly follow- up visits.Results: Patients were included at a median disease duration of 2.0 months. During a me- dian follow- up of 59 (interquartile range = 43- 71) months, 82% of patients had ongoing disease activity as demonstrated by failing the no evidence of disease activity 3 (NEDA-3) criteria, and 19% presented with confirmed disability worsening. A GCIP threshold of <= 77 mu m at baseline identified patients with a high risk for NEDA- 3 failure (hazard ratio [HR] = 1.7, 95% confidence interval [CI] = 1.1- 2.8, p = 0.04), and GCIP measures of <= 69 mu m predicted disability worsening (HR = 2.2, 95% CI = 1.2-4.3, p = 0.01). Higher rates of annualized GCIP loss increased the risk for disability worsening (HR = 2.5 per 1 mu m/year increase of GCIP loss, p = 0.03).Conclusions: Ganglion cell thickness as measured by OCT after the initial manifestation of multiple sclerosis may allow early risk stratification as to future disease activity and progression.

• Item Type: Journal article
• Faculties: Medicine > Munich Cluster for Systems Neurology (SyNergy)
• Subjects: 600 Technology > 610 Medicine and health
• Language: English
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198