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Vol. 26, Art. 23 (pp. 542-571)    |    2025       

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The role of retinal imaging in neurodegenerative diseases. Part 2. Multiple sclerosis

Kolesnikova E.T.1, Tultseva S.N.2

1 Federal State Budgetary Educational Institution of Higher Education «Izhevsk State Medical Academy» of the Ministry of Healthcare of Russian Federation. Russia, Udmurt Republic, Izhevsk, Kommunarov street, 281

2 Federal State Budgetary Educational Institution of Higher Education “Academician I.P. Pavlov First St. Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation. Russia, 197022,
Saint-Petersburg, Lva Tolstogo street, 6-8

Brief summary

The aim of this review was to systematically examine the role of optical coherence tomography (OCT) and OCT angiography (OCTA) in assessing neurodegenerative changes of the retina and optic nerve in patients with multiple sclerosis (MS), as well as to analyze their correlation with clinical and neurological parameters. Particular attention was paid to the potential use of retinal parameters, such as the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), as biomarkers of neurodegeneration, and to evaluate the impact of baseline immunomodulatory therapy on the rate of retinal atrophy. Literature review showed that even in the absence of clinical manifestations of optic neuritis, MS patients exhibit significant thinning of the RNFL (on average by 7.08 μm compared to the control group) and GCC. In patients with a history of optic neuritis, these changes were even more pronounced (a decrease in RNFL thickness by 20.38 μm). It was established that RNFL thickness correlates with the EDSS scale and the volume of gray and white matter in the brain. It was also found that drugs such as natalizumab and anti-CD20 antibodies demonstrate the highest neuroprotective efficacy, reducing the rate of GCC atrophy to 0.09-0.1% per year. Importantly, OCTA revealed a decrease in vessel density and perfusion in the area of the optic nerve, which may serve as an early marker of microcirculatory disturbances in MS. The review emphasizes the importance of integrating OCT and OCTA into clinical practice for early diagnosis, monitoring, and assessment of therapeutic response in MS patients, especially through the use of quantitative retinal parameters.


Key words

Multiple sclerosis; neurodegeneration, neuroopticopathy, optical coherence tomography, optic nerve, optic neuritis

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