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Evidence of retinal anterograde neurodegeneration in the very early stages of multiple sclerosis: a longitudinal OCT study

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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.

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Acknowledgments

The authors thank Beatrice Clementi (University of Milan, Italy) for helping in collecting the data of the study.

Funding

This research was supported by the Italian Ministry of Health (Ricerca Corrente to ES, FV, and FT).

Author information

Author notes

  1. Anna M. Pietroboni and Tiziana Carandini contributed equally to this work.

Authors and Affiliations

  1. Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy

    Anna M. Pietroboni, Tiziana Carandini, Annalisa Colombi, Milena A. De Riz, Andrea Arighi, Giorgio G. Fumagalli, Daniela Galimberti & Elio Scarpini

  2. Dino Ferrari Center, Milan, Italy

    Anna M. Pietroboni, Tiziana Carandini, Annalisa Colombi, Milena A. De Riz, Chiara Fenoglio, Andrea Arighi, Giorgio G. Fumagalli, Daniela Galimberti & Elio Scarpini

  3. Ophthalmological Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Laura Dell’Arti & Francesco Viola

  4. Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy

    Francesca Bovis

  5. University of Milan, Milan, Italy

    Elena Casazza, Chiara Fenoglio, Giorgio G. Fumagalli, Fabio Triulzi, Daniela Galimberti, Francesco Viola & Elio Scarpini

  6. Neuroradiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Elisa Scola & Fabio Triulzi

Authors
  1. Anna M. Pietroboni
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Correspondence to Anna M. Pietroboni.

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Pietroboni, A.M., Carandini, T., Dell’Arti, L. et al. Evidence of retinal anterograde neurodegeneration in the very early stages of multiple sclerosis: a longitudinal OCT study. Neurol Sci 41, 3175–3183 (2020). https://doi.org/10.1007/s10072-020-04431-4

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  • DOI: https://doi.org/10.1007/s10072-020-04431-4

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