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Vol. 27, Art. 43 (pp. 1069-1090)    |    2026       

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Possibilities of optical coherence tomography in the assessment of subclinical neuroopticopathy in patients with multiple sclerosis

Kolesnikova E.T.1, Tultseva S.N.2
1 Federal State Budgetary Educational Institution of Higher Education «Izhevsk State Medical University» 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

Introduction. Multiple sclerosis is characterized by demyelination and axonal degeneration. Damage to the visual pathways is detected in the vast majority of patients, including in the form of subclinical neuroopticopathy, even in the absence of a history of clinically manifested optic neuritis. The purpose of the study. To evaluate the structural changes of the retina and optic nerve according to optical coherence tomography in patients with various types of multiple sclerosis to identify signs of subclinical neuroopticopathy. Materials and methods. 165 patients (330 eyes) were examined: 115 patients with multiple sclerosis, without a clinically verified history of retrobulbar neuritis, and 50 patients in the control group. All participants underwent a standard ophthalmological examination, including optical coherence tomography with an analysis of the thickness of the retinal nerve fiber layer, the ganglion cell complex, and the parameters of the optic disc with an assessment of dynamics as well as an assessment of the relationship of these parameters with the presence of multiple sclerosis activity according to MRI data. Results. In patients with multiple sclerosis, there was a significant decrease in the average thickness of the retinal nerve fiber layer (89±14,5 microns versus 101,3±7.3 microns; p<0,001) and the ganglion cell complex (87,2±11,7 microns versus 97,8±5,8 microns; p<0,001) compared with the control and dynamic observation. The most pronounced structural changes were observed in the secondary progressive type of multiple sclerosis. In patients with disease progression, according to magnetic resonance imaging of the brain, the area of the neuroretinal girdle significantly decreased (1,074±0,329 mm2 versus 1,284±0,378 mm2; p=0,037) and the ratio of the excavation area to the area of the optic disc increased. Discussion. Optical coherence tomography is a highly informative noninvasive method for detecting subclinical neuro-optic pathology. Multiple sclerosis is most characterized by thinning of the peripapillary layer of nerve fibers in the temporal sectors, as well as diffuse thinning of the ganglion cell complex, along with morphological changes in the optic disc (a decrease in the area of the neuroretinal girdle and an increase in excavation), which serve as reliable biomarkers of axonal degeneration and can be used to monitor the subclinical progression of the disease.


Key words

Multiple sclerosis; remitting multiple sclerosis; secondary progressive multiple sclerosis; primary progressive multiple sclerosis; neurodegeneration; subclinical neuroopticopathy; optical coherence tomography

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