Optical coherence tomography segmentation analysis in relapsing remitting versus progressive multiple sclerosis

• Published in: PloS one Vol. 12; no. 2; p. e0172120
• Main Authors: Behbehani, Raed, Abu Al-Hassan, Abdullah, Al-Salahat, Ali, Sriraman, Devarajan, Oakley, J D, Alroughani, Raed
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13-02-2017; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Atrophy; Atrophy - diagnostic imaging; Atrophy - physiopathology; Biology and Life Sciences; Brain research; Care and treatment; Comparative analysis; Correlation; Cross-Sectional Studies; Degeneration; Disease Progression; Eye (anatomy); Female; Genetic aspects; Humans; Ibn Sina (980-1037); Image segmentation; Linear Models; Male; Medical records; Medicine and Health Sciences; Middle Aged; Multiple sclerosis; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - physiopathology; Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging; Multiple Sclerosis, Relapsing-Remitting - physiopathology; Neuritis; Neurodegeneration; Neurology; Optic neuritis; Optic Neuritis - diagnostic imaging; Optic Neuritis - physiopathology; Optical Coherence Tomography; Optics; Pathology; Patients; Photoreceptors; Physical Sciences; Physiological aspects; Reproducibility of Results; Research and Analysis Methods; Retina; Retina - diagnostic imaging; Retina - pathology; Retina - physiopathology; Retinal Ganglion Cells - pathology; Risk factors; Segmentation; Social Sciences; Studies; Tomography; Tomography, Optical Coherence - methods; Young Adult; United States; Kuwait; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0172120

Optical coherence tomography (OCT) with retinal segmentation analysis is a valuable tool in assessing axonal loss and neuro-degeneration in multiple sclerosis (MS) by in-vivo imaging, delineation and quantification of retinal layers. There is evidence of deep retinal involvement in MS beyond the inner retinal layers. The ultra-structural retinal changes in MS in different MS phenotypes can reflect differences in the pathophysiologic mechanisms. There is limited data on the pattern of deeper retinal layer involvement in progressive MS (PMS) versus relapsing remitting MS (RRMS). We have compared the OCT segmentation analysis in patients with relapsing-remitting MS and progressive MS.
Cross-sectional study of 113 MS patients (226 eyes) (29 PMS, 84 RRMS) and 38 healthy controls (72 eyes). Spectral domain OCT (SDOCT) using the macular cube acquisition protocol (Cirrus HDOCT 5000; Carl Zeiss Meditec) and segmentation of the retinal layers for quantifying the thicknesses of the retinal layers. Segmentation of the retinal layers was carried out utilizing Orion software (Voxeleron, USA) for quantifying the thicknesses of individual retinal layers.
The retinal nerve finer layer (RNFL) (p = 0.023), the ganglion-cell/inner plexiform layer (GCIPL) (p = 0.006) and the outer plexiform layer (OPL) (p = 0.033) were significantly thinner in PMS compared to RRMS. There was significant negative correlation between the outer nuclear layer (ONL) and EDSS (r = -0.554, p = 0.02) in PMS patients. In RRMS patients with prior optic neuritis, the GCIPL correlated negatively (r = -0.317; p = 0.046), while the photoreceptor layer (PR) correlated positively with EDSS (r = 0.478; p = 0.003).
Patients with PMS exhibit more atrophy of both the inner and outer retinal layers than RRMS. The ONL in PMS and the GCIPL and PR in RRMS can serve as potential surrogate of disease burden and progression (EDSS). The specific retinal layer predilection and its correlation with disability may reflect different pathophysiologic mechanisms and various stages of progression in MS.