Retinal nerve fiber layer thickness in multiple sclerosis with and without optic neuritis: a four-year follow-up study from Oman

BMC Ophthalmol. 2021 Nov 12;21(1):391. doi: 10.1186/s12886-021-02158-0.


Background: Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system, with optic neuritis (ON) being a common early manifestation. Retinal nerve fiber layer (RNFL) thickness may be a biomarker of neuroaxonal damage in MS patients. We sought to evaluate changes in RNFL thickness over 4 years in Omani MS patients with or without ON in comparison to a healthy control group.

Methods: This retrospective case-control study involved 27 MS patients and 25 healthy controls. Optical coherence tomography was performed upon first diagnosis and at a four-year follow-up. Differences in mean RNFL thickness were calculated.

Results: A total of 51 eyes from the MS group and 50 eyes from the control group were evaluated. There was a significant reduction in mean RNFL thickness among MS patients with ON at follow-up (81.21 versus 72.14 μm; P = .003), whereas no significant RNFL thinning was observed among MS patients without ON. However, there was a significant reduction in RNFL thickness among MS patients compared to healthy controls (76.79 versus 93.72 μm; P = .009), regardless of ON presence/absence.

Conclusions: Axonal damage was seen in the optic nerves of Omani MS patients. Moreover, there was a significant reduction in RNFL thickness among MS patients with ON as the disease progressed; however, while there was evidence of RNFL thinning in MS patients without ON, this difference lacked statistical significance. Evaluation of RNFL thickness may represent a useful biomarker for monitoring disease progression in MS and its association with ON.

Keywords: Multiple sclerosis; Optic neuritis; Optical coherence tomography; Retinal nerve Fiber layer.

MeSH terms

  • Case-Control Studies
  • Follow-Up Studies
  • Humans
  • Multiple Sclerosis* / complications
  • Nerve Fibers
  • Oman / epidemiology
  • Optic Neuritis* / diagnosis
  • Optic Neuritis* / etiology
  • Retrospective Studies
  • Tomography, Optical Coherence