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Monitoring the Course of MS With Optical Coherence Tomography

  • Multiple Sclerosis and Related Disorders (P Villoslada, Section Editor)
  • Published:
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Opinion statement

Retinae of patients with multiple sclerosis (MS), as part of the central nervous system (CNS), display inflammatory and neurodegenerative changes. There is increasing evidence suggesting that retinal changes, and in particular neurodegeneration, mirror global CNS alterations in MS. Spectral domain optical coherence tomography (SD-OCT) is an inexpensive, rapid, non-invasive, and reproducible imaging technique that generates high-resolution images of tissues such as the retina. An advantage of SD-OCT over magnetic resonance imaging techniques in the assessment of neurodegeneration may be its sensitivity to capture changes at the individual patient level. Several studies demonstrate that changes within the inner retina (primarily as a reflection of optic neuropathy), as assessed by OCT, correlate with reduced quality of life, visual dysfunction, and global disability in MS. Moreover, longitudinal studies suggest that inner retinal thinning is an early phenomenon in MS and that retinal thinning may occur independent of previous symptomatic episodes of optic neuritis, significantly correlating with inflammatory disease. Preliminary studies suggest that MS disease-modifying therapies may have differential effects on OCT-determined rates of retinal atrophy, supporting a potential utility for OCT to investigate the neuroprotective benefits of disease-modifying therapies in MS, as well as an outcome in trials of putatively neuroprotective strategies.

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    Authors and Affiliations

    1. NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany

      Alexander U. Brandt MD

    2. Hospital Clinic of Barcelona, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Rosello 149, 08306, Barcelona, Spain

      Elena H. Martinez-Lapiscina MD phD

    3. New York University School of Medicine, New York, NY, USA

      Rachel Nolan BA

    4. Johns Hopkins University, Baltimore, MD, USA

      Shiv Saidha MBBCh, MD, MRCPI

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    Correspondence to Elena H. Martinez-Lapiscina MD phD.

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    Funding

    Alexander U. Brandt received funding from the German Federal Ministry for Economic Affairs and Energy (BMWi Exist 03EFEBE079).

    Elena H. Martinez-Lapiscina received funding from the Instituto de Salud Carlos III, Spain, and Fondo Europeo de Desarrollo Regional (FEDER; JR16/00006), Grant for MS Innovation and Marató TV3 Charitable Foundation.

    Rachel Nolan declares no funding.

    Shiv Saidha received funding from the Race to Erase MS and Genentech Corporation.

    Conflict of Interest

    Alexander U. Brandt has received travel reimbursement from Bayer, Biogen, Teva, and Novartis and consulting or speaker honoraria from Biogen, Teva, Heidelberg Engineering, Motognosis, and Nexus. He is a member of the working committee of International Multiple Sclerosis Visual System (IMSVISUAL) Consortium.

    Elena H. Martinez-Lapiscina is a researcher in the OCTIMS Study, an observational study (which involves no specific drugs) to validate SD-OCT as a biomarker for multiple sclerosis, sponsored by Novartis. She has received speaking honoraria from Biogen and Genzyme and travel reimbursement from Genzyme, Roche, for international and national meetings over the last 3 years. She is a member of the working committee of the International Multiple Sclerosis Visual System (IMSVISUAL) Consortium.

    Rachel Nolan is a member of the working committee of the International Multiple Sclerosis Visual System (IMSVISUAL) Consortium.

    Shiv Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology, consulting fees from Axon Advisors LLC, speaking honoraria from the National Association of Managed Care Physicians, Family Medicine Foundation of West Virginia, and Advanced Studies in Medicine, and served on scientific advisory boards for Biogen-Idec, Genzyme, Genentech Corporation, and Novartis. He received research support from the Race to Erase MS and Genentech Corporation. He is a member of the working committee of the International Multiple Sclerosis Visual System (IMSVISUAL) Consortium.

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    This article does not contain any studies with human or animal subjects performed by any of the authors.

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    This article is part of the Topical Collection on Multiple Sclerosis and Related Disorders

    Alexander U. Brandt, Elena H. Martinez-Lapiscina, Rachel Nolan and Shiv Saidha contributed equally to this work.

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    Brandt, A.U., Martinez-Lapiscina, E.H., Nolan, R. et al. Monitoring the Course of MS With Optical Coherence Tomography. Curr Treat Options Neurol 19, 15 (2017). https://doi.org/10.1007/s11940-017-0452-7

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