Retinal macrophage-like cell activation and ganglion cell layer thinning are associated with disability and MRI lesion burden in multiple sclerosis
Abstract
Background: Multiple sclerosis is a chronic neuroinflammatory disease in which microglia and macrophage-like cells play a central role in disease progression. The retina, as a central nervous system extension accessible to non-invasive imaging, offers a unique window into these processes.
Objective: The aim of this study was to determine whether retinal macrophage-like cell characteristics and ganglion cell layer thickness are associated with clinical disability and magnetic resonance imaging lesion burden in patients with multiple sclerosis.
Methods: In this cross-sectional observational study, patients with multiple sclerosis and age-matched healthy controls underwent retinal imaging using spectral-domain optical coherence tomography and swept-source optical coherence tomography angiography. Macrophage-like cells at the vitreoretinal interface were quantified using an automated image-processing pipeline, while ganglion cell layer and retinal nerve fibre layer thicknesses were measured using standardized segmentation. Clinical disability was assessed using the Expanded Disability Status Scale, the 9-Hole Peg Test, and the 25-Foot Walk. Brain magnetic resonance imaging lesion counts were obtained from T1- and T2-weighted sequences.
Results: Overall retinal macrophage-like cell parameters did not differ between patients with multiple sclerosis and controls. However, patients with greater disability, defined as an Expanded Disability Status Scale score of five or higher,…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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