retinal layer atrophy in PPMS/SPMS

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retinal layer atrophy in PPMS/SPMS

Post by frodo » Fri Apr 17, 2020 1:42 am

This could shade some light into the pathogenesis. By the way, there is no myelin in the retina. ... /ana.25738

Progressive multiple sclerosis is associated with faster and specific retinal layer atrophy


Therapeutic development in progressive multiple sclerosis (PMS) has been hampered by a lack of reliable biomarkers to monitor neurodegeneration. Optical coherence tomography (OCT)‐derived retinal measures have been proposed as promising biomarkers to fulfill this role. However, it is unclear if retinal atrophy persists in PMS, exceeds normal aging, or can be distinguished from relapsing–remitting MS (RRMS).


178 RRMS, 186 PMS, and 66 control participants were followed with serial OCT for a median follow‐up of 3.7 years.


The estimated proportion of peri‐papillary retinal nerve fiber layer (pRNFL) and macular ganglion cell+inner plexiform layer (GCIPL) thinning in MS attributable to normal aging increased from 42.7% and 16.7% respectively at age 25 years, to 83.7% and 81.1% at age 65 years. However, independent of age, PMS was associated with faster pRNFL (−0.34 ± 0.09%/year; p < 0.001) and GCIPL (−0.27 ± 0.07%/year; p < 0.001) thinning, as compared to RRMS. In both MS and controls, higher baseline age was associated with faster inner (INL) and outer nuclear layer (ONL) thinning. INL and ONL thinning were independently faster in PMS, as compared to controls (INL:‐0.09 ± 0.04%/year, p = 0.03; ONL:‐0.12 ± 0.06%/year, p = 0.04), and RRMS (INL:‐0.10 ± 0.04%/year, p = 0.01; ONL:‐0.13 ± 0.05%/year, p = 0.01), while they were similar in RRMS and controls. Unlike RRMS, disease‐modifying therapies (DMTs) did not impact rates of retinal layer atrophy in PMS.


PMS is associated with faster retinal atrophy independent of age. INL and ONL measures may be novel biomarkers of neurodegeneration in PMS, that appear to be unaffected by conventional DMTs. The effects of aging on rates of retinal layer atrophy should be considered in clinical trials incorporating OCT outcomes.

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