Anna M Pietroboni1,2, Tiziana Carandini3,4, Laura Dell'Arti5, Francesca Bovis6, Annalisa Colombi3,4, Milena A De Riz3,4, Elena Casazza7, Elisa Scola8, Chiara Fenoglio4,7, Andrea Arighi3,4, Giorgio G Fumagalli3,4,7, Fabio Triulzi7,8, Daniela Galimberti3,4,7, Francesco Viola5,7, Elio Scarpini3,4,7. 1. Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. pb.anna@libero.it. 2. Dino Ferrari Center, Milan, Italy. pb.anna@libero.it. 3. Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. 4. Dino Ferrari Center, Milan, Italy. 5. Ophthalmological Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 6. Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. 7. University of Milan, Milan, Italy. 8. Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
BACKGROUND: Neurodegenerative processes are present since the early stages of multiple sclerosis (MS), constituting the primary substrate of disability. As part of the CNS, retinal damage could be considered a reliable prognostic biomarker of neurodegeneration in MS. OBJECTIVES: To characterize longitudinal changes in the retinal layers' thickness and to investigate correlations between retinal atrophy and other prognostic biomarkers, i.e., cerebrospinal fluid (CSF) β-amyloid1-42 (Aβ) levels. METHODS: Forty-two eyes without a history of optic neuritis of 23 MS patients were recruited. All patients underwent spectral-domain-OCT scans (SD-OCT), brain magnetic resonance imaging (MRI), and lumbar puncture at baseline. SD-OCT and brain MRI were repeated after 12 months. Ten controls underwent the same OCT procedure. RESULTS: At baseline, macular ganglion cell/inner plexiform layer (mGCIPL) thickness was reduced in patients compared to controls (p = 0.008), without retinal nerve fiber layer (RNFL) thinning, that was revealed only at follow-up (p = 0.005). Patients with lower CSF Aβ levels displayed reduced RNFL thickness values, both at baseline and follow-up. CONCLUSIONS: At very early clinical stages, mGCIPL thickness values were reduced without a concomitant peripapillary RNFL thinning. The longitudinal assessment demonstrated a RNFL loss in patients compared to HC, together with a plateau of mGCIPL thinning. Aβlow subgroup of patients showed a reduction of retinal nerve fiber layer thickness.
BACKGROUND: Neurodegenerative processes are present since the early stages of multiple sclerosis (MS), constituting the primary substrate of disability. As part of the CNS, retinal damage could be considered a reliable prognostic biomarker of neurodegeneration in MS. OBJECTIVES: To characterize longitudinal changes in the retinal layers' thickness and to investigate correlations between retinal atrophy and other prognostic biomarkers, i.e., cerebrospinal fluid (CSF) β-amyloid1-42 (Aβ) levels. METHODS: Forty-two eyes without a history of optic neuritis of 23 MS patients were recruited. All patients underwent spectral-domain-OCT scans (SD-OCT), brain magnetic resonance imaging (MRI), and lumbar puncture at baseline. SD-OCT and brain MRI were repeated after 12 months. Ten controls underwent the same OCT procedure. RESULTS: At baseline, macular ganglion cell/inner plexiform layer (mGCIPL) thickness was reduced in patients compared to controls (p = 0.008), without retinal nerve fiber layer (RNFL) thinning, that was revealed only at follow-up (p = 0.005). Patients with lower CSF Aβ levels displayed reduced RNFL thickness values, both at baseline and follow-up. CONCLUSIONS: At very early clinical stages, mGCIPL thickness values were reduced without a concomitant peripapillary RNFL thinning. The longitudinal assessment demonstrated a RNFL loss in patients compared to HC, together with a plateau of mGCIPL thinning. Aβlow subgroup of patients showed a reduction of retinal nerve fiber layer thickness.
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