Optical coherence tomography reflects clinically relevant gray matter damage in patients with multiple sclerosis

Alessandro Cagol, Nuria Cerdá Fuertes, Marc Stoessel, Muhamed Barakovic, Sabine Schaedelin, Marcus D’Souza, Jens Würfel, Alexander U. Brandt, Ludwig Kappos, Till Sprenger, Yvonne Naegelin, Jens Kuhle, Cristina Granziera, Athina Papadopoulou

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Retinal degeneration leading to optical coherence tomography (OCT) changes is frequent in patients with multiple sclerosis (PwMS). Objective: To investigate associations among OCT changes, MRI measurements of global and regional brain volume loss, and physical and cognitive impairment in PwMS. Methods: 95 PwMS and 52 healthy controls underwent OCT and MRI examinations. Mean peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell/inner plexiform layer (GCIPL) volume were measured. In PwMS disability was quantified with the Expanded Disability Status Scale (EDSS) and Symbol Digit Modalities Test (SDMT). Associations between OCT, MRI, and clinical measures were investigated with multivariable regression models. Results: In PwMS, pRNFL and GCIPL were associated with the volume of whole brain (p < 0.04), total gray matter (p < 0.002), thalamus (p ≤ 0.04), and cerebral cortex (p ≤ 0.003) –both globally and regionally–, but not white matter. pRNFL and GCIPL were also inversely associated with T2-lesion volume (T2LV), especially in the optic radiations (p < 0.0001). The brain volumes associated with EDSS and SDMT significantly overlapped with those correlating with pRNFL and GCIPL. Conclusions: In PwMS, pRNFL and GCIPL reflect the integrity of clinically-relevant gray matter structures, underling the value of OCT measures as markers of neurodegeneration and disability in multiple sclerosis.

Original languageEnglish
Pages (from-to)2139-2148
Number of pages10
JournalJournal of Neurology
Issue number4
StatePublished - Apr 2023
Externally publishedYes


  • Brain atrophy
  • Ganglion cells
  • MRI
  • MS
  • Neurodegeneration
  • OCT


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