Optical Coherence Tomography In Multiple Sclerosis PDF Download

Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) affecting more than two million people worldwide. The disease is characterised by inflammation in the CNS (leading to episodes of focal neurological dysfunction, i.e. relapses) and neurodegeneration (leading to progressive and permanent disability). Depending on the localisation of the CNS damage, patients exhibit a wide range of symptoms including muscle weakness, sensory disturbances, problems with coordination, fatigue and cognitive impairment. Visual symptoms are common as well, with more dan 50% of MS patients experiencing one or more episodes of optic neuritis (ON) during the course of the disease. The disease course in MS is highly variable and difficult to predict. However, predicting the disease course is crucial for determining the proper treatment. This thesis focuses on how optical coherence tomography (OCT) can aid in monitoring and predicting the disease course in patients with MS. OCT is an imaging technique that generates high resolution images of the retina and all its layers. The inner two retinal layers consist of the retinal ganglion cells and their axons that will eventually form the optic nerve. Thereby, these two layers are directly connected to the brain. Previous research has demonstrated that previous episodes of ON result in atrophy (thinning) of these two layers. Sometimes, it can be challenging to establish whether a patient has ever experienced an episode of optic neuritis clinically. The absolute thickness of the retinal layers is not a good indicator for this. Our research shows that the difference in retinal layer thickness between the eyes of a single patient can, with high accuracy, discriminate ON patients from non-ON patients. Being able to establish the presence of a previous episode of ON in this way, might lead to an earlier diagnosis of MS and earlier treatment.