A recent large-scale study has revealed new insights into the structural changes of the retina in multiple sclerosis (MS) patients, highlighting potential biomarkers for disease monitoring and severity assessment. Researchers analyzed optical coherence tomography (OCT) data from 507 MS patients and 183 healthy controls to investigate the thickness of individual inner retinal layers in the macular region, a part of the retina crucial for vision.
Macular Retinal Changes Reflect Multiple Sclerosis
The study focused on four retinal layers: the nerve fibre layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL). Compared with healthy controls, thinning varied between 3% and 20%, with the greatest difference in those with primary progressive MS and secondary progressive MS.
Results showed that the NFL was significantly thinner in all MS subtypes, primary progressive (PP), relapsing-remitting (RR), and secondary progressive (SP), with the most severe thinning observed in PP and SP subgroups. GCL and IPL also exhibited thinning proportional to disease severity, notably most pronounced in the SP group. Interestingly, the INL thickness varied with MS subtype: it was increased in the RR group but reduced in the SP group, suggesting different inflammatory or degenerative processes at different stages of the disease.
Inner Layers Show Distinct Patterns
These retinal changes correlated with disease severity and duration, indicating their potential role in tracking global neurodegeneration in MS. The study emphasizes that the macular NFL may serve as a robust biomarker for global brain atrophy and disease progression. Furthermore, the similar thinning trends of the GCL and IPL support measuring these layers combined for increased precision in monitoring MS-related neural damage.
OCT Enables Non-Invasive Monitoring
Importantly, the research excluded patients with recent optic neuritis to avoid confounding effects, enhancing the reliability of the retinal thickness measures as indicators of MS pathology independent of acute optic nerve inflammation.
This study underscores the value of OCT as a fast, safe, and non-invasive technique for assessing neurodegeneration in MS and supports its use in clinical practice to better understand disease progression and tailor treatment strategies.
Reference
Zahavi O et al. Macular inner retinal layers in multiple sclerosis. Front Neurol. 2025;doi:10.3389/fneur.2025.1549091.
