pRNFL as a marker of disability worsening in the medium/long term in patients with MS

MS is an inflammatory and neurodegenerative disease of the CNS (including the retina) that leads to progressive neurologic disability. Disability correlates with the degree of axonal pathology in the disease.1,2 The clinical course of MS is unpredictable, making the search for biomarkers associated with enhanced risk of disease progression a major unmet need. Spectral domain optical coherence tomography (SD-OCT) is a potential predictor of disability worsening up to 5 years of follow-up after a single evaluation of the peripapillary retinal nerve fiber layer (pRNFL).3 Time domain OCT (TD-OCT) is an older technology, characterized by lower axial resolution and slower acquisition speed (400 axial scans per second) resulting in lower resolution images and more frequent motion artifacts compared with SD-OCT.4 TD-OCT was used over 10 years ago to assess retinal neurodegeneration in patients with MS but only now has enough time passed to assess its actual predictive potential for clinical progression.