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Optical coherence tomography angiography indicates subclinical retinal disease in neuromyelitis optica spectrum disorders.

Mult Scler. 2021 Jul 14:13524585211028831. doi: 10.1177/13524585211028831. Epub ahead of print. PMID: 34259579.

Authors/Editors: Aly L, Strauß EM, Feucht N, Weiß I, Berthele A, Mitsdoerffer M, Haass C, Hemmer B, Maier M, Korn T, Knier B.
Publication Date: 2021


Background: Neuromyelitis optica spectrum disorders (NMOSD) are neuroinflammatory diseases of the central nervous system. Patients suffer from recurring relapses and it is unclear whether relapse-independent disease activity occurs and whether this is of clinical relevance.

Objective: To detect disease-specific alterations of the retinal vasculature that reflect disease activity during NMOSD.

Methods: Cross-sectional analysis of 16 patients with NMOSD, 21 patients with relapsing-remitting multiple sclerosis, and 21 healthy controls using retinal optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), measurement of glial fibrillary acidic protein (GFAP) serum levels, and assessment of visual acuity.

Results: Patients with NMOSD but not multiple sclerosis revealed lower foveal thickness (FT) (p = 0.02) measures and an increase of the foveal avascular zone (FAZ) (p = 0.02) compared to healthy controls independent to optic neuritis. Reduced FT (p = 0.01), enlarged FAZ areas (p = 0.0001), and vessel loss of the superficial vascular complex (p = 0.01) were linked to higher serum GFAP levels and superficial vessel loss was associated with worse visual performance in patients with NMOSD irrespective of optic neuritis.

Conclusion: Subclinical parafoveal retinal vessel loss might occur during NMOSD and might be linked to astrocyte damage and poor visual performance. OCT-A may be a tool to study subclinical disease activity during NMOSD.

Keywords: Neuromyelitis optica spectrum disorders; astrocytes; biomarker; disease activity; optical coherence tomography angiography.

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