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Inner retinal layer thinning in radiologically isolated syndrome predicts conversion to multiple sclerosis.

Eur J Neurol. 2020;10.1111/ene.14416. doi:10.1111/ene.14416 [published online ahead of print, 2020 Jun 26].

Authors/Editors: Aly L, Havla J, Lepennetier G, Andlauer TFM, Sie C, Strauß EM, Hoshi MM, Kümpfel T, Hiltensperger M, Mitsdoerffer M, Mühlau M, Zimmer C, Hemmer B, Korn T, Knier B.
Publication Date: 2020



Background Individuals with radiologically syndrome (RIS) are at increased risk of converting to multiple sclerosis (MS). Early identification of later converters is crucial for optimal treatment decisions. The purpose of this study was to assess the predictive potential of OCT measures in individuals with RIS regarding conversion to MS.

Methods This prospective observational cohort study included 36 individuals with RIS and 36 healthy controls (HC) recruited from two German MS centers. All individuals received a baseline OCT and clinical examination and were longitudinally followed over up to six years. The primary outcome measure was the conversion to MS.

Results During clinical follow‐up of 46 (26–58) months (median, 25%–75% interquartile range), eight individuals with RIS converted to MS. Individuals converting to MS showed a thinning of the peripapillary retinal nerve fiber layer (pRNFL) and the common ganglion cell and inner plexiform layer (GCIP) at baseline and during follow‐up. Individuals with a pRNFL of 99 µm or lower or a GCIP of 1.99 mm3 or lower were at a 7.5 and 8.0‐fold risk for MS conversion, respectively, compared to individuals with higher measures. After correction for other known risk factors, Cox proportional hazards regression revealed a hazard ratio of 1.08 for conversion to MS for each 1 µm decline in pRNFL.

Conclusions Reduction of the pRNFL might be a novel and independent risk factor for conversion to MS in individuals with RIS. OCT might be useful for risk stratification and therapeutic decision‐making in individuals with RIS.

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