Evidence of retinal anterograde neurodegeneration in the very early stages of multiple sclerosis: a longitudinal OCT stu
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ORIGINAL ARTICLE
Evidence of retinal anterograde neurodegeneration in the very early stages of multiple sclerosis: a longitudinal OCT study Anna M. Pietroboni 1,2 & Tiziana Carandini 1,2 & Laura Dell’Arti 3 & Francesca Bovis 4 & Annalisa Colombi 1,2 & Milena A. De Riz 1,2 & Elena Casazza 5 & Elisa Scola 6 & Chiara Fenoglio 2,5 & Andrea Arighi 1,2 & Giorgio G. Fumagalli 1,2,5 & Fabio Triulzi 5,6 & Daniela Galimberti 1,2,5 & Francesco Viola 3,5 & Elio Scarpini 1,2,5 Received: 3 February 2020 / Accepted: 13 April 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Neurodegenerative processes are present since the early stages of multiple sclerosis (MS), constituting the primary substrate of disability. As part of the CNS, retinal damage could be considered a reliable prognostic biomarker of neurodegeneration in MS. Objectives To characterize longitudinal changes in the retinal layers’ thickness and to investigate correlations between retinal atrophy and other prognostic biomarkers, i.e., cerebrospinal fluid (CSF) β-amyloid1–42 (Aβ) levels. Methods Forty-two eyes without a history of optic neuritis of 23 MS patients were recruited. All patients underwent spectraldomain-OCT scans (SD-OCT), brain magnetic resonance imaging (MRI), and lumbar puncture at baseline. SD-OCT and brain MRI were repeated after 12 months. Ten controls underwent the same OCT procedure. Results At baseline, macular ganglion cell/inner plexiform layer (mGCIPL) thickness was reduced in patients compared to controls (p = 0.008), without retinal nerve fiber layer (RNFL) thinning, that was revealed only at follow-up (p = 0.005). Patients with lower CSF Aβ levels displayed reduced RNFL thickness values, both at baseline and follow-up. Conclusions At very early clinical stages, mGCIPL thickness values were reduced without a concomitant peripapillary RNFL thinning. The longitudinal assessment demonstrated a RNFL loss in patients compared to HC, together with a plateau of mGCIPL thinning. Aβlow subgroup of patients showed a reduction of retinal nerve fiber layer thickness. Keywords Multiple sclerosis . OCT . Neurodegeneration . β-Amyloid . Biomarkers
Introduction Anna M. Pietroboni and Tiziana Carandini contributed equally to this work. * Anna M. Pietroboni [email protected] 1
Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
2
Dino Ferrari Center, Milan, Italy
3
Ophthalmological Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
4
Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
5
University of Milan, Milan, Italy
6
Neuroradiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Multiple sclerosis (MS) represents a potentially severe cause of disability throughout adult life [1]. Alongside with chronic inflammation of the central nervous system (CNS), neurodegenerative processes may be present since the early stages of MS, constituting the primary substrate of
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