Comparison of Peripapillary Retinal Nerve Fiber Layer Thickness in Patients with MS and Normal Population

To compare peripapillary retinal nerve fiber layer thickness (RNFLT) between patients with multiple sclerosis (MS) and healthy controls using optical coherence tomography (OCT).

In this prospective case control study, peripapillary RNFLT of 120 eyes from 60 patients with multiple sclerosis (MS)  was compared to 120 eyes from 60 age and sex matched healthy controls using OCT.  The RNFLT in 4 peripapillary quadrants and the mean RNFLT of all four quadrants were compared between the case and control groups. The relation between MS variables such as age of onset, type and duration of disease, history of optic neuritis (ON) and other non-ocular episodes with RNFLT was evaluated in the case group.

The mean RNFLT of all four quarters was significantly lower in patients with MS compared to the controls (P < 0.001). Also RNFLT was significantly lower in each of 4 quadrants (superior, temporal, inferior; P < 0.001, nasal P = 0.003). There was no significant relation between RNFLT, the age of onset of MS disease, and history of non-ocular episodes. RNFLT had a significant relation with duration of the disease (P < 0.001), the type of MS (P < 0.001), history of ON (P = 0.002), and the number of ON episodes (P = 0.021). 

We found that RNFLT decreases in MS patients and its reduction is related to the duration and type of disease as well as history and number of ON episodes. Therefore measuring RNFLT may help in estimating the progress of MS and can potentially be included as a part of patients’ follow up protocol.