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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 03, 2023
Accepted:
January 2,
2023
Received in revised form:
October 21,
2022
Received:
May 14,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
