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Journal of Neuroinflammation
Published in: Journal of Neuroinflammation 1/2023

Open Access 01-12-2023 | Multiple Sclerosis | Review

Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis

Authors: Soheil Mohammadi, Mahdi Gouravani, Mohammad Amin Salehi, J. Fernando Arevalo, Steven L. Galetta, Hamid Harandi, Elliot M. Frohman, Teresa C. Frohman, Shiv Saidha, Neda Sattarnezhad, Friedemann Paul

Published in: Journal of Neuroinflammation | Issue 1/2023

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Abstract

Background and objectives

Recent literature on multiple sclerosis (MS) demonstrates the growing implementation of optical coherence tomography–angiography (OCT-A) to discover potential qualitative and quantitative changes in the retina and optic nerve. In this review, we analyze OCT-A studies in patients with MS and examine its utility as a surrogate or precursor to changes in central nervous system tissue.

Methods

PubMed and EMBASE were systematically searched to identify articles that applied OCT-A to evaluate the retinal microvasculature measurements in patients with MS. Quantitative data synthesis was performed on all measurements which were evaluated in at least two unique studies with the same OCT-A devices, software, and study population compared to controls. A fixed-effects or random-effects model was applied for the meta-analysis based on the heterogeneity level.

Results

The study selection process yielded the inclusion of 18 studies with a total of 1552 evaluated eyes in 673 MS-associated optic neuritis (MSON) eyes, 741 MS without optic neuritis (MSNON eyes), and 138 eyes without specification for the presence of optic neuritis (ON) in addition to 1107 healthy control (HC) eyes. Results indicated that MS cases had significantly decreased whole image superficial capillary plexus (SCP) vessel density when compared to healthy control subjects in the analyses conducted on Optovue and Topcon studies (both P < 0.0001). Likewise, the whole image vessel densities of deep capillary plexus (DCP) and radial peripapillary capillary (RPC) were significantly lower in MS cases compared to HC (all P < 0.05). Regarding optic disc area quadrants, MSON eyes had significantly decreased mean RPC vessel density compared to MSNON eyes in all quadrants except for the inferior (all P < 0.05). Results of the analysis of studies that used prototype Axsun machine revealed that MSON and MSNON eyes both had significantly lower ONH flow index compared to HC (both P < 0.0001).

Conclusions

This systematic review and meta-analysis of the studies reporting OCT-A measurements of people with MS confirmed the tendency of MS eyes to exhibit reduced vessel density in the macular and optic disc areas, mainly in SCP, DCP, and RPC vessel densities.
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Metadata
Title
Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis
Authors
Soheil Mohammadi
Mahdi Gouravani
Mohammad Amin Salehi
J. Fernando Arevalo
Steven L. Galetta
Hamid Harandi
Elliot M. Frohman
Teresa C. Frohman
Shiv Saidha
Neda Sattarnezhad
Friedemann Paul
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Neuroinflammation / Issue 1/2023
Electronic ISSN: 1742-2094
DOI
https://doi.org/10.1186/s12974-023-02763-4

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