Lower baseline retinal thickness in patients with MS correla
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Decreased ganglion cell-inner plexiform layer thickness at baseline as assessed by optical coherence tomography correlated with a four-fold greater risk for long-term disability worsening in MS, according to findings published in Neurology.

This study aimed to evaluate whether a retinal spectral-domain optical coherence tomography (SD-OCT) assessment at baseline is associated with long-term disability worsening in people with multiple sclerosis (PwMS), researchers performed SD-OCT and Expanded Disability Status Scale (EDSS) assessments among 132 PwMS at baseline and at a median of 10 years later.

In this prospective, longitudinal study, participants underwent SD-OCT, EDSS, and visual acuity (VA) assessments at baseline and at follow-up. Statistical analyses were performed using generalized linear regression models, adjusted for age, sex, race, MS subtype, and baseline disability. Clinically meaningful EDSS worsening was defined as an increase of more than 2.0 if baseline EDSS score was less than 6.0, or an increase of more than 1.0 if baseline EDSS score was more than 6.0.

Results:
-- 132 PwMS (mean age: 43 years; n=106 patients with relapsing remitting MS) were included in analyses. Median duration of follow-up was 10.4 years.

-- In multivariable models excluding eyes with prior optic neuritis, relative to patients with an average baseline ganglion cell+inner plexiform layer (GCIPL) thickness more than 70µm (the mean GCIPL thickness of all eyes at baseline), an average baseline GCIPL thickness less than 70µm was associated with a 4-fold increased odds of meaningful EDSS worsening, and an almost 3-fold increased odds of low-contrast VA worsening.

Conclusively, lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS. Accordingly, SD-OCT at a single time-point may help to guide therapeutic decision making among individual PwMS.

This study provides Class I evidence that lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS.

Source: https://n.neurology.org/content/early/2021/03/01/WNL.0000000000011788?rss=1
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