New Study Reveals Improved Diagnosis for Multiple Sclerosis

Researchers from the Department of Neurology at MedUni Vienna and University Hospital Vienna conducted a study that reveals a significant improvement in the diagnosis of multiple sclerosis (MS) by measuring the thickness of retinal layers in the eye.

The procedure, already available in the aforementioned departments, aids in early detection and more accurate prediction of MS progression. These advancements can greatly enhance patient outcomes. The findings were published in the journal Neurology.

The research team, led by Gabriel Bsteh and Thomas Berger from the Department of Neurology at MedUni Vienna and University Hospital Vienna, collaborated with colleagues from the Department of Ophthalmology and Optometrics at MedUni Vienna and University Hospital Vienna. Together, they examined 267 MS patients over a period of five years.

Their investigation builds upon a previous study published in 2022, which indicated that damage to the retina due to MS relapses corresponds to the extent of brain damage in patients. The earlier study also established that a reduction of 5 micrometers (µm) in retinal layer thickness following optic neuritis indicates a doubling of the risk of permanent disability after subsequent relapses. With the inclusion of a large cohort of MS patients in their latest research, the team has confirmed that retinal layer thickness can serve as a precise biomarker for aiding in early diagnosis.

OCT Used as Diagnostic Procedure

The researchers utilized optical coherence tomography (OCT), an existing diagnostic procedure, to measure the thickness of the retinal layer. OCT employs infrared light to generate detailed three-dimensional images of thin tissue layers, measuring as little as a few micrometers (1 µm = 1/1,000th of a millimeter). This imaging method is also valuable in diagnosing and monitoring the progression of eye conditions like glaucoma.

Gabriel Bsteh, the study's primary author, commented on the availability of OCT, stating, "We already have this procedure at our disposal. When combined with current diagnostic criteria for MS, optical coherence tomography provides significantly more accurate and earlier results. This enables us to initiate treatment measures sooner, greatly improving long-term outcomes for patients."

Retina as a Window on the Brain

Multiple sclerosis is a chronic inflammatory disease that affects the nervous system, causing inflammation and loss of nerve cells due to autoimmune responses. As the initial damage often goes unnoticed by patients, diagnosis is frequently delayed until the disease has progressed significantly, resulting in missed opportunities for effective treatment.

Due to the critical role that early detection and prognosis play in MS cases, medical researchers have been searching for improved detection methods to minimize severe consequences such as impaired mobility and blindness.

Bsteh summarized the study's primary finding, stating, "We have identified retinal layer thickness as a novel biomarker for diagnosing MS, essentially serving as a window to the brain." Future research phases will focus on assessing the significance of retinal layer thickness in measuring responses to MS treatment.

Reference

Gabriel Bsteh et al, Diagnostic Performance of Adding the Optic Nerve Region Assessed by Optical Coherence Tomography to the Diagnostic Criteria for MS, Neurology (2023). DOI: 10.1212/WNL.0000000000207507