Optical coherence tomography versus other biomarkers: Associations with physical and cognitive disability in multiple sclerosis

Nuria Cerdá-Fuertes, Marc Stoessel, Gintaras Mickeliunas, Silvan Pless, Alessandro Cagol, Muhamed Barakovic, Aleksandra Maleska Maceski, Cesar Álvarez González, Marcus D’ Souza, Sabine Schaedlin, Pascal Benkert, Pasquale Calabrese, Konstantin Gugleta, Tobias Derfuss, Till Sprenger, Cristina Granziera, Yvonne Naegelin, Ludwig Kappos, Jens Kuhle, Athina Papadopoulou

Research output: Contribution to journalArticlepeer-review


Background: Optical coherence tomography (OCT) is a biomarker of neuroaxonal loss in multiple sclerosis (MS). Objective: The objective was to assess the relative role of OCT, next to magnetic resonance imaging (MRI) and serum markers of disability in MS. Methods: A total of 100 patients and 52 controls underwent OCT to determine peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layers (GCIPL). Serum neurofilament light chain (sNfL), total lesion volume (TLV), and brain parenchymal fraction (BPF) were also assessed. The associations of OCT with disability were examined in linear regression models with correction for age, vision, and education. Results: In patients, pRNFL was associated with the Symbol Digit Modalities Test (SDMT; p = 0.030). In the multivariate analysis including sNfL and MRI measures, pRNFL (β = 0.19, p = 0.044) and TLV (β = −0.24, p = 0.023) were the only markers associated with the SDMT. pRNFL (p < 0.001) and GCIPL (p < 0.001) showed associations with the Expanded Disability Status Scale (EDSS). In the multivariate analysis, GCIPL showed the strongest association with the EDSS (β = −0.32, p < 0.001) followed by sNfL (β = 0.18, p = 0.024). Conclusion: The associations of OCT measures with cognitive and physical disability were independent of serum and brain MRI markers of neuroaxonal loss. OCT can be an important tool for stratification in MS, while longitudinal studies using combinations of biomarkers are warranted.

Original languageEnglish
Pages (from-to)1540-1550
Number of pages11
JournalMultiple Sclerosis Journal
Issue number13
StatePublished - Nov 2023


  • EDSS
  • OCT
  • RNFL
  • SDMT


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