Association of the retinal vasculature, intrathecal immunity, and disability in multiple sclerosis
Background Optical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing remitting multiple sclerosis (RRMS), retinal vessel loss occurs in eyes suffering from acute optic neuritis and recent data suggest that reti...
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Published in | Frontiers in immunology Vol. 13; p. 997043 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
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11.11.2022
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Abstract | Background
Optical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing remitting multiple sclerosis (RRMS), retinal vessel loss occurs in eyes suffering from acute optic neuritis and recent data suggest that retinal vessel loss might also be evident in non-affected eyes. We investigated whether alterations of the retinal vasculature are linked to the intrathecal immunity and whether they allow prognostication of the future disease course.
Material and methods
This study includes two different patient cohorts recruited at a tertiary German academic multiple sclerosis center between 2018 and 2020 and a cohort of 40 healthy controls. A total of 90 patients with RRMS undergoing lumbar puncture and OCT-A analysis were enrolled into a cross-sectional cohort study to search for associations between the retinal vasculature and the intrathecal immune compartment. We recruited another 86 RRMS patients into a prospective observational cohort study who underwent clinical examination, OCT-A and cerebral magnetic resonance imaging at baseline and during annual follow-up visits to clarify whether alterations of the retinal vessels are linked to RRMS disease activity. Eyes with a history of optic neuritis were excluded from the analysis.
Results
Rarefication of the superficial vascular complex occured during RRMS and was linked to higher frequencies of activated B cells and higher levels of the pro-inflammatory cytokines interferon-γ, tumor necrosis factor α and interleukin-17 in the cerebrospinal fluid. During a median follow-up of 23 (interquartile range 14 - 25) months, vessel loss within the superficial (hazard ratio [HR] 1.6 for a 1%-point decrease in vessel density, p=0.01) and deep vascular complex (HR 1.6 for a 1%-point decrease, p=0.05) was associated with future disability worsening.
Discussion
Optic neuritis independent rarefication of the retinal vasculature might be linked to neuroinflammatory processes during RRMS and might predict a worse disease course. Thus, OCT-A might be a novel biomarker to monitor disease activity and predict future disability. |
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AbstractList | Background
Optical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing remitting multiple sclerosis (RRMS), retinal vessel loss occurs in eyes suffering from acute optic neuritis and recent data suggest that retinal vessel loss might also be evident in non-affected eyes. We investigated whether alterations of the retinal vasculature are linked to the intrathecal immunity and whether they allow prognostication of the future disease course.
Material and methods
This study includes two different patient cohorts recruited at a tertiary German academic multiple sclerosis center between 2018 and 2020 and a cohort of 40 healthy controls. A total of 90 patients with RRMS undergoing lumbar puncture and OCT-A analysis were enrolled into a cross-sectional cohort study to search for associations between the retinal vasculature and the intrathecal immune compartment. We recruited another 86 RRMS patients into a prospective observational cohort study who underwent clinical examination, OCT-A and cerebral magnetic resonance imaging at baseline and during annual follow-up visits to clarify whether alterations of the retinal vessels are linked to RRMS disease activity. Eyes with a history of optic neuritis were excluded from the analysis.
Results
Rarefication of the superficial vascular complex occured during RRMS and was linked to higher frequencies of activated B cells and higher levels of the pro-inflammatory cytokines interferon-γ, tumor necrosis factor α and interleukin-17 in the cerebrospinal fluid. During a median follow-up of 23 (interquartile range 14 - 25) months, vessel loss within the superficial (hazard ratio [HR] 1.6 for a 1%-point decrease in vessel density, p=0.01) and deep vascular complex (HR 1.6 for a 1%-point decrease, p=0.05) was associated with future disability worsening.
Discussion
Optic neuritis independent rarefication of the retinal vasculature might be linked to neuroinflammatory processes during RRMS and might predict a worse disease course. Thus, OCT-A might be a novel biomarker to monitor disease activity and predict future disability. BackgroundOptical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing remitting multiple sclerosis (RRMS), retinal vessel loss occurs in eyes suffering from acute optic neuritis and recent data suggest that retinal vessel loss might also be evident in non-affected eyes. We investigated whether alterations of the retinal vasculature are linked to the intrathecal immunity and whether they allow prognostication of the future disease course. Material and methodsThis study includes two different patient cohorts recruited at a tertiary German academic multiple sclerosis center between 2018 and 2020 and a cohort of 40 healthy controls. A total of 90 patients with RRMS undergoing lumbar puncture and OCT-A analysis were enrolled into a cross-sectional cohort study to search for associations between the retinal vasculature and the intrathecal immune compartment. We recruited another 86 RRMS patients into a prospective observational cohort study who underwent clinical examination, OCT-A and cerebral magnetic resonance imaging at baseline and during annual follow-up visits to clarify whether alterations of the retinal vessels are linked to RRMS disease activity. Eyes with a history of optic neuritis were excluded from the analysis. ResultsRarefication of the superficial vascular complex occured during RRMS and was linked to higher frequencies of activated B cells and higher levels of the pro-inflammatory cytokines interferon-γ, tumor necrosis factor α and interleukin-17 in the cerebrospinal fluid. During a median follow-up of 23 (interquartile range 14 - 25) months, vessel loss within the superficial (hazard ratio [HR] 1.6 for a 1%-point decrease in vessel density, p=0.01) and deep vascular complex (HR 1.6 for a 1%-point decrease, p=0.05) was associated with future disability worsening. DiscussionOptic neuritis independent rarefication of the retinal vasculature might be linked to neuroinflammatory processes during RRMS and might predict a worse disease course. Thus, OCT-A might be a novel biomarker to monitor disease activity and predict future disability. |
Author | Noll, Christina Aly, Lilian Hiltensperger, Michael Wicklein, Rebecca Gasperi, Christiane Korn, Thomas Berthele, Achim Afzali, Ali Maisam Hemmer, Bernhard Knier, Benjamin Mardin, Christian |
AuthorAffiliation | 2 Institute for Experimental Neuroimmunology, TUM School of Medicine, Technical University of Munich , Munich , Germany 4 Department of Ophthalmology, University Hospital of Erlangen-Nuremberg , Erlangen , Germany 1 Department of Neurology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich , Munich , Germany 3 Munich Cluster of Systems Neurology (SyNergy) , Munich , Germany |
AuthorAffiliation_xml | – name: 1 Department of Neurology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich , Munich , Germany – name: 4 Department of Ophthalmology, University Hospital of Erlangen-Nuremberg , Erlangen , Germany – name: 2 Institute for Experimental Neuroimmunology, TUM School of Medicine, Technical University of Munich , Munich , Germany – name: 3 Munich Cluster of Systems Neurology (SyNergy) , Munich , Germany |
Author_xml | – sequence: 1 givenname: Christina surname: Noll fullname: Noll, Christina – sequence: 2 givenname: Michael surname: Hiltensperger fullname: Hiltensperger, Michael – sequence: 3 givenname: Lilian surname: Aly fullname: Aly, Lilian – sequence: 4 givenname: Rebecca surname: Wicklein fullname: Wicklein, Rebecca – sequence: 5 givenname: Ali Maisam surname: Afzali fullname: Afzali, Ali Maisam – sequence: 6 givenname: Christian surname: Mardin fullname: Mardin, Christian – sequence: 7 givenname: Christiane surname: Gasperi fullname: Gasperi, Christiane – sequence: 8 givenname: Achim surname: Berthele fullname: Berthele, Achim – sequence: 9 givenname: Bernhard surname: Hemmer fullname: Hemmer, Bernhard – sequence: 10 givenname: Thomas surname: Korn fullname: Korn, Thomas – sequence: 11 givenname: Benjamin surname: Knier fullname: Knier, Benjamin |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 This article was submitted to Multiple Sclerosis and Neuroimmunology, a section of the journal Frontiers in Immunology Reviewed by: Hadas Stiebel-Kalish, Tel Aviv University, Israel; Anneke Van Der Walt, Department of Neuroscience, Monash University, Australia Edited by: Ingo Kleiter, Marianne-Strauss-Klinik, Germany |
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Snippet | Background
Optical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing... BackgroundOptical coherence tomography angiography (OCT-A) is a novel technique allowing non-invasive assessment of the retinal vasculature. During relapsing... |
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StartPage | 997043 |
SubjectTerms | cerebrospinal fluid disability Immunology multiple sclerosis Optical coherence tomography optical coherence tomography angiography |
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Title | Association of the retinal vasculature, intrathecal immunity, and disability in multiple sclerosis |
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