Researchers discovered that ganglion cells plus the inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) measurements predict physical and cognitive neurodegeneration in patients with multiple sclerosis (MS) after 6 years, as published in the Multiple Sclerosis Journal.

GCIPL and pRNFL thinning correlate with physical and cognitive disability progression and are established biomarkers of axonal degeneration in patients with MS. Optical coherence tomography (OCT) enables the measurement of these distinct retinal layers via noninvasive and inexpensive techniques and can be used to explore and enhance the diagnosis and prognosis of these patients.

The team from the Department of Neurology at the Medical University Innsbruck in Austria included 93 patients from the MS outpatient clinic and conducted clinical study visits biannually for 6 years. Patients with a diagnosis of relapsing MS and at least 1 eye without a history of optic neuritis <6 months prior to baseline were included in the study.

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OCT imaging was performed after 1, 2, and 6 years without pupil dilation in a dark room on both eyes of each patient, and the main thickness of the inner four quadrants of the grid was assessed.

The results of the study revealed GCIPL and pRNFL thinning as statistically significant predictors of long-term disability progression. Furthermore, the team also concluded that effects were more pronounced using GCIPL than pRNFL, and stronger for predicting Expanded Disability Status Scale worsening than cognitive deterioration.

While evidence on the value of retinal thinning for the prediction of long-term disability in MS is scarce, this study substantiates the predictive value of OCT-based retinal thinning and emphasizes individualized treatment in MS by embedding OCT scans into the clinical routine.


Berek K, Hegen H, Hocher J, et al. Retinal layer thinning as a biomarker of long-term disability progression in multiple sclerosisMult Scler. Published online June 2, 2022. doi:10.1177/13524585221097566