Utilizing Retinal Nerve Fiber Layer Thinning (RNFL) via OCT as a Non-invasive Measure of Neurodegenerative Burden in Multiple Sclerosis: A Retrospective Study
Manal Taha Hadrawi1, Hossam Younis2, Mostafa Meshref3, Nooran Badeeb4
1Pediatric Ophthalmology Consultant and Head of Ophthalmology department in King Fahad Armed Forces Hospital, 2Neurology specialist at Neuroscience department King Fahad Armed Forces, Jeddah, Saudi Arabia., 3Department of Neurology, Faculty of MedicineAl-Azhar University, Cairo, 44-Department of Surgery, Division of Ophthalmology, University of Jeddah, Jeddah, Saudi Arabia, Department Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
Objective:
This study aimed to assess the correlation between RNFL thickness and disease severity in MS patients in absence of previous optic neuritis (ON).
Background:
Multiple sclerosis (MS) is a chronic neurological disorder marked by inflammatory demyelination and axonal degeneration. Optical coherence tomography (OCT) has emerged as a prospective biomarker for neurodegeneration, particularly via assessments of retinal nerve fiber layer (RNFL) thickness.
Design/Methods:
This retrospective analysis was performed on 81 multiple sclerosis patients (71.6% female, mean age 35 years) with no prior history of optic neuritis. The thickness of the RNFL was assessed using OCT and compared with normal values. Clinical factors, such as Expanded Disability Status Scale (EDSS) scores and disease duration, were examined for relationships with retinal nerve fiber layer (RNFL) thickness.
Results:
The average RNFL thickness in MS patients (87.7 ± 13.0 µm) was substantially lower than that of healthy controls (110.01 ± 7.39 µm, p < 0.001), with the most pronounced thinning occurring in the nasal quadrant (−26.98%). An negative connection was identified between RNFL thickness and EDSS scores (r = −0.34, p = 0.034), with patients with substantial disability demonstrating reduced RNFL thickness (74.6 ± 8.1 µm) relative to those with light disability (89.4 ± 12.8 µm). No notable correlation was detected with disease duration (p = 0.838). Patients receiving high-efficacy disease-modifying treatments (DMTs) had enhanced preservation of retinal nerve fiber layer (RNFL) (p = 0.04).
Conclusions:
There are strong correlations between clinical decline and RNFL thickness as evaluated by optical OCT, making it a sensitive and non-invasive indicator of neurodegeneration in multiple sclerosis (MS). The results show that OCT is useful for tracking subclinical axonal loss, especially in moderately disabled people. In order to confirm that high-efficacy DMTs have neuroprotective benefits and to find the best way to incorporate OCT into MS care procedures, more prospective trials are required.
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