Optical Coherence Tomography Reliable Monitor of MS Disease Progression

4. Diagnostic Challenges
4. Diagnostic Challenges
OCT would also be useful as an outcome in investigative clinical trials.

Optical coherence tomography (OCT) may be useful in monitoring multiple sclerosis (MS) disease progression, and may be suitable as an investigative outcome in trials, research indicates.

The study, published in Annals of Neurology, aimed to determine whether brain atrophy — as seen with OCT — was a valid indicator of neuronal tissue damage in multiple sclerosis. Shiv Saidha, MD, of Johns Hopkins University, and colleagues analyzed individual rates of change in retinal and brain structure measures using 3T MRI and cirrus high-definition OCT in 107 patients with MS.

CLINICAL CHART: Multiple Sclerosis Treatments

The researchers found that rates of ganglion cell + inner plexiform layer (GCIP) and whole-brain (r = 0.45; P< 0.001), gray matter (GM; r = 0.37; P< 0.001), white matter (WM; r = 0.28; P= 0.007), and thalamic (r = 0.38; P< 0.001) atrophy were associated, with GCIP and whole-brain atrophy more strongly associated in progressive MS (r = 0.67; P< 0.001) compared to relapsing-remitting MS (RRMS) (r = 0.33; P= 0.007). In RRMS, lesion accumulation rate was linked with GCIP (r = −0.30; P= 0.02) and inner nuclear layer (r = −0.25; P= 0.04) atrophy rates. Correlation between rates of GCIP and whole-brain (including gray matter and white matter) atrophy in RRMS increased incrementally with step-wise refinement to exclude effects from optic neuritis (ON). When excluding eyes and then patients, the correlation increased from 0.45 to 0.60, which is consistent with effect modification.

Over time, GCIP seems to reflect underlying MS disease progression, mirroring whole-brain, particularly gray matter, atrophy, especially in patients with progressive MS. Therefore, OCT appears to be a viable option for use in clinical monitoring of disease progression and as an investigative outcome in clinical trials.


  1. Saidha S et al. Ann Neurol. 2015; doi:10.1002/ana.24487.