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Research Article| Volume 70, 104505, February 2023

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Significant retinal microvascular impairments in multiple sclerosis assessed through optical coherence tomography angiography

  • Xuejiao Wang
    Affiliations
    Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Department of Ophthalmology, Beijing Jishuitan Hospital, Beijing, 100035, China
    Search for articles by this author
  • Xuqian Wang
    Affiliations
    Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
    Search for articles by this author
  • Yuyu Chou
    Affiliations
    Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
    Search for articles by this author
  • Jin Ma
    Affiliations
    Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
    Search for articles by this author
  • Yong Zhong
    Correspondence
    Corresponding author at: Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
    Affiliations
    Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
    Search for articles by this author
Published:January 03, 2023DOI:https://doi.org/10.1016/j.msard.2023.104505

      Highlight

      • We analyzed retinal vascular density detected by OCTA in 1803 eyes.
      • Retinal microcirculation was significantly reduced in patients with MS.
      • This decrease in vascular density is more significantly in RPC and SCP.
      • Our finding is helpful to explore the pathological changes of MS.
      • Vessel density may serve as a vital marker for the diagnosis and changes of MS.

      Abstract

      Purpose

      Multiple sclerosis (MS) is associated with different ocular disorders. This study aimed to investigate the retinal microvascular changes detected by optical coherence tomography angiography (OCTA) in eyes with MS with or without a history of optic neuritis (ON).

      Methods

      A comprehensive literature search was conducted in the Web of Science, Embase, PubMed, and Cochrane Library databases on September 26, 2021 for articles focused on OCTA manifestations in the eyes of MS patients compared with healthy controls. RevMan Manager (v.5.4) and Stata (v.14.1) were used to analyze the main differences and publication risks. Weighted mean differences and 95% confidence intervals were calculated for continuous estimates. This study also included subgroup analysis between three groups: eyes with multiple sclerosis and with optic neuritis (MSON); eyes with multiple sclerosis and without optic neuritis (MSNON); and healthy controls.

      Results

      Thirteen studies with a total of 1803 eyes were identified, including 957 eyes with MS and 846 eyes of healthy controls. The vessel density of the MS eyes decreased significantly in most areas of the radial peripapillary capillary. A marked reduction in the macular superficial capillary plexus of MS eyes regardless of ON history was also confirmed.

      Conclusion

      The results suggest that MS patients demonstrated significant retinal microvasculature impairment regardless of ON history, compared to healthy controls. Retinal vessel density attenuation detected by OCTA may serve as a reliable early marker of MS.

      Keywords

      Abbreviations:

      MS (multiple sclerosis), CNS (central nervous system), ON (optic neuritis), ONH (optic nerve head), RNFL (retinal nerve fiber layer), OCTA (optical coherence tomography angiography), VD (vessel density), RPC (radial peripapillary capillary), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), SCP (superficial capillary plexus), DCP (deep capillary plexus), EDSS (Expanded Disability Status Scale), MSON (multiple sclerosis with optic neuritis), MSNON (multiple sclerosis without optic neuritis), WMD (weighted mean difference), CI (confidence interval), RRMS (relapsing remitting multiple sclerosis), SPMS (secondary progressive multiple sclerosis), PPMS (primary progressive multiple sclerosis), IQR (interquartile range)
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