Retinal measurements predict 10-year disability in multiple sclerosis

Alissa Rothman, Olwen C. Murphy, Kathryn C. Fitzgerald, Julia Button, Eliza Gordon-Lipkin, John N. Ratchford, Scott D. Newsome, Ellen M. Mowry, Elias S. Sotirchos, Stephanie B. Syc-Mazurek, James Nguyen, Natalia Gonzalez Caldito, Laura J. Balcer, Elliot M. Frohman, Teresa C. Frohman, Daniel S. Reich, Ciprian Crainiceanu, Shiv Saidha, Peter A. Calabresi

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: Optical coherence tomography (OCT)-derived measures of the retina correlate with disability and cortical gray matter atrophy in multiple sclerosis (MS); however, whether such measures predict long-term disability is unknown. We evaluated whether a single OCT and visual function assessment predict the disability status 10 years later. Methods: Between 2006 and 2008, 172 people with MS underwent Stratus time domain-OCT imaging [160 with measurement of total macular volume (TMV)] and high and low-contrast letter acuity (LCLA) testing (n = 150; 87%). All participants had Expanded Disability Status Scale (EDSS) assessments at baseline and at 10-year follow-up. We applied generalized linear regression models to assess associations between baseline TMV, peripapillary retinal nerve fiber layer (pRNFL) thickness, and LCLA with 10-year EDSS scores (linear) and with clinically significant EDSS worsening (binary), adjusting for age, sex, optic neuritis history, and baseline disability status. Results: In multivariable models, lower baseline TMV was associated with higher 10-year EDSS scores (mean increase in EDSS of 0.75 per 1 mm 3 loss in TMV (mean difference = 0.75; 95% CI: 0.11–1.39; P = 0.02). In analyses using tertiles, individuals in the lowest tertile of baseline TMV had an average 0.86 higher EDSS scores at 10 years (mean difference = 0.86; 95% CI: 0.23–1.48) and had over 3.5-fold increased odds of clinically significant EDSS worsening relative to those in the highest tertile of baseline TMV (OR: 3.58; 95% CI: 1.30–9.82; P trend = 0.008). pRNFL and LCLA predicted the 10-year EDSS scores only in univariate models. Interpretation: Lower baseline TMV measured by OCT significantly predicts higher disability at 10 years, even after accounting for baseline disability status.

Original languageEnglish (US)
Pages (from-to)222-232
Number of pages11
JournalAnnals of Clinical and Translational Neurology
Issue number2
StatePublished - Feb 2019

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Neurology


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