Retinal thinning differentiates treatment effects in relapsing multiple sclerosis below the clinical threshold

• Published in: Annals of clinical and translational neurology 2024-12
• Main Authors: Bsteh, Gabriel, Hegen, Harald, Krajnc, Nik, Föttinger, Fabian, Altmann, Patrick, Auer, Michael, Berek, Klaus, Kornek, Barbara, Leutmezer, Fritz, Macher, Stefan, Monschein, Tobias, Ponleitner, Markus, Rommer, Paulus, Schmied, Christiane, Zebenholzer, Karin, Zulehner, Gudrun, Zrzavy, Tobias, Deisenhammer, Florian, Di Pauli, Franziska, Pemp, Berthold, Berger, Thomas
• Format: Article
• Language: English
• ISSN: 2328-9503; 2328-9503
• DOI: 10.1002/acn3.52279

To investigate retinal layer thinning as a biomarker of disease-modifying treatment (DMT) effects in relapsing multiple sclerosis (RMS). From an ongoing prospective observational study, we included patients with RMS, who (i) had an optical coherence tomography (OCT) scan within 6 to 12 months after DMT start (rebaseline) and ≥1 follow-up OCT ≥12 months after rebaseline and (ii) adhered to DMT during follow-up. Differences between DMT in thinning of peripapillary-retinal-nerve-fiber-layer (pRNFL) and macular ganglion cell-plus-inner plexiform-layer (GCIPL) were analyzed using mixed-effects linear regression. Eyes suffering optic neuritis during follow-up were excluded. We included 291 RMS patients (mean age 30.8 years [SD 7.9], 72.9% female, median disease duration 9 months [range 6-94], median rebaseline-to-last-follow-up-interval 32 months [12-82]). Mean annualized rates of retinal layer thinning (%/year) in reference to DMF (n = 84, GCIPL 0.28, pRNFL 0.53) were similar under TERI (n = 18, GCIPL 0.34, pRNFL 0.59), GLAT (n = 24, GCIPL 0.32, pRNFL 0.56), and IFNb (n = 13, GCIPL 0.33, pRNFL 0.60) were slightly lower under S1PM (n = 27, GCIPL 0.19, pRNFL 0.42) and CLA (n = 23, GCIPL 0.20, pRNFL 0.42), and were significantly lower under NTZ (n = 47, GCIPL 0.09, pRNFL 0.24; both p