Optical coherence tomography for long-term assessment of the optic neuritis in relapsing-remitting multiple sclerosis

Abstract

Background: Optic neuritis (ON) is a common early manifestation of relapsing-remitting multiple sclerosis (RRMS), occurring at onset or during relapses. Recent MS criteria include the optic nerve, highlighting the need for accurate assessment. Optical coherence tomography (OCT) enables noninvasive evaluation of retinal layers and is a sensitive biomarker of neuroaxonal loss. Objective: To investigate long-term visual and structural outcomes in RRMS patients with a history of ON. Methods: This retrospective, descriptive, and analytical study included 55 RRMS patients with at least one ON episode. Patients underwent visual acuity (VA), color vision (CV), computerized visual field (VF), and OCT assessments. Data were analyzed using IBM SPSS Statistics and JASP (v0.18.1). The study was approved by the HUGG Research Ethics Committee. Results: The sample included 55 patients (81.8% women, 72.7% white) with a mean disease duration of 17.5 ± 8.25 years. Among 110 eyes, 82 had ON. Normal VA (logMAR 0.0) was observed in 70.7% with ON (58 eyes) and 89.2% without ON (25 eyes). CV was normal in 71.8%. VF (139 eyes) showed MD −5.05 dB with ON ( 58 eyes), −3.92 dB without ON (21 eyes), and −2.11 dB in the control group ( 60 eyes). OCT (162 eyes) revealed a mean pRNFL thickness of 77.24 μm with ON (75 eyes), 83.14 μm without ON (27 eyes), and 98.36 μm in the control group (60 eyes). Conclusion: RRMS patients generally preserve good visual function despite ON. OCT detects structural changes even in eyes without clinical ON, confirming its value as a sensitive biomarker of neuroaxonal damage.