Application Of OCT/OCTA In Patients With Multiple Sclerosis And Neuromyelitis Optica

Objective : To study the changes and significance of optical coherence tomography/optical coherence tomography angiography(OCT/OCTA)in patients with multiple sclerosis and neuromyelitis optica.Methods: This study was a retrospective analysis,a total of 45patients(86 eyes)diagnosed with multiple sclerosis(MS)and neuromyelitis optica spectrum disorder(NMOSD)in Xiangya Hospital of Central South University from January 2020 to May 2022,as well as 13 other outpatients(22 eyes)as the control group.According to the history of optic neuritis,the patients’ eyes were divided into multiple sclerosis related optic neuritis(MS-ON)group,multiple sclerosis non optic neuritis(MS-NON)group,neuromyelitis optica spectrum disorder related optic neuritis(NMOSD-ON)group and neuromyelitis optica non optic neuritis(NMOSD-NON)group.Collected the clinical data and OCT/OCTA results of the patients,and the OCT/OCTA changes in MS patients and NMOSD patients were analyzed.Results:1.Compared with the control group,the macular thickness,RNFL thickness and GCL thickness were decreased in MS-ON group,MS-NON group,and NMOSD-ON group(P<0.05),while the nasal of RNFL thickness decreased in NMOSD-NON group(P<0.05);there was no difference in OCT indexes between the MS-ON group and the MS-NON group(P>0.05);the macular thickness,RNFL thickness and GCL thickness in the NMOSD-ON group were smaller than those in the NMOSD-NON group(P<0.05);2.Compared with the control group,superficial capillary plexus vessel density decreased in MS-ON group and NMOSD-ON group(P<0.05);radial peripapillary capillaries vessel density decreased in the MS-ON group,the MS-NON group,the NMOSD-ON group,and the NMOSD-NON group,among which the nasal of vascular density decreased in the MS-NON group;the superior,inferior,and temporal of vascular density decreased in the NMOSD-ON group,the lower blood vascular density decreased in the NMOSD-NON group(P<0.05);3.The RNFL thickness in MS patients was positively correlated with the vascular density around the optic disc(r=0.545),and the thickness of RNFL in NMOSD patients was positively correlated with the vascular density around the optic disc(r=0.798);the generalized estimating equation was used to analyze while the average thickness of RNFL as the control variable,radial peripapillary capillaries vessel density still had a tendency downward in the NMOSD-ON group(B=-1.23,P=0.064);4.Compared with MS patients with equal or less than three recurrences,the macular thickness,RNFL thickness of MS patients with more than three recurrences were smaller(P<0.05);5.With the increase in the number of cranial magnetic resonance lesions in MS patients,MS macular thickness decreased in W1,W2,N1,and N2 regions,and the average RNFL thickness and temporal RNFL thickness decreased(P<0.05).Conclusion:1.Subclinical retinal damage may be present in NMOSD patients;the retinal structural damage in MS patients is not related to ON,but the retinal structural damage in NMOSD patients is related to ON;2.ON episodes in NMOSD patients may directly lead to optic disc vascular damage;3.The number of recurrences and lesions in MS patients was related to retinal structural damage,and OCT could be an indicator for monitoring disease activity during long-term follow-up of MS patients.