Hyperreflective retinal foci are associated with retinal degeneration after optic neuritis in neuromyelitis optica spectrum disorders and multiple sclerosis

• Published in: European journal of neurology 2025-01, Vol.32 (1), p.e70038-n/a
• Main Authors: Klyscz, Philipp, Vigiser, Ifat, Solorza Buenrostro, Gilberto, Motamedi, Seyedamirhosein, Leutloff, Carla Johanna, Schindler, Patrick, Schmitz‐Hübsch, Tanja, Paul, Friedemann, Zimmermann, Hanna Gwendolyn, Oertel, Frederike Cosima
• Format: Article
• Language: English
• Subjects: Adult; Aquaporin 4; Autoimmune diseases; Cross-Sectional Studies; Data acquisition; Degeneration; Eye; Female; Humans; hyperreflective retinal foci; Immunoglobulin G; Male; Microglia; Middle Aged; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - pathology; Neuritis; Neurodegeneration; Neuromyelitis; Neuromyelitis Optica - complications; Neuromyelitis Optica - diagnostic imaging; Neuromyelitis Optica - pathology; neuromyelitis optica spectrum disorder; OCT; Optic neuritis; Optic Neuritis - diagnostic imaging; Optic Neuritis - pathology; Optical Coherence Tomography; Retina; Retina - diagnostic imaging; Retina - pathology; Retinal degeneration; Retinal Degeneration - diagnostic imaging; Retinal Degeneration - etiology; Retinal Degeneration - pathology; Retinal ganglion cells; Thickness; Tomography, Optical Coherence
• ISSN: 1351-5101; 1468-1331; 1468-1331
• DOI: 10.1111/ene.70038

Background Hyperreflective retinal foci (HRF) visualized by optical coherence tomography (OCT) potentially represent clusters of microglia. We compared HRF frequencies and their association with retinal neurodegeneration between people with clinically isolated syndrome (pwCIS), multiple sclerosis (pwMS), aquaporin 4‐IgG positive neuromyelitis optica spectrum disorder (pwNMOSD), and healthy controls (HC)—as well as between eyes with (ON+eyes) and without a history of optic neuritis (ON−eyes). Methods Cross‐sectional data of pwCIS, pwMS, and pwNMOSD with previous ON and HC were acquired at Charité—Universitätsmedizin Berlin. HRF analysis was performed manually on the central macular OCT scan. Semi‐manual OCT segmentation was performed to acquire the combined ganglion cell and inner plexiform layer (GCIPL), inner nuclear layer (INL), and peripapillary retinal nerve fiber layer (pRNFL) thickness. Group comparisons were performed by linear mixed models. Results In total, 227 eyes from 88 patients (21 pwCIS, 32 pwMS, and 35 pwNMOSD) and 35 HCs were included. HRF in GCIPL and INL were more frequently detected in pwCIS, pwMS, and pwNMOSD than HCs (p