Oct-A and Perimetry in Multiple Sclerosis

The aim of this work is to investigate the correlation between visual field parameters and optical coherence tomography angiography (OCT-A) findings in patients with multiple sclerosis (MS). MS is a chronic autoimmune demyelinating disease that frequently involves the visual pathway, often presenting with optic neuritis (ON) and subsequent neurodegeneration. OCT-A, a non-invasive imaging modality, enables detailed visualization and quantification of retinal microvasculature, particularly the superficial and deep capillary plexuses, which supply the retinal ganglion cells and nerve fiber layers. Previous studies have demonstrated reduced retinal vessel density and thinning of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) in MS patients, reflecting neuro-axonal damage and microvascular impairment. However, the relationship between these structural and vascular changes and functional visual outcomes, such as visual field loss, remains to be fully elucidated.

This study aims to assess retinal vascular density using OCT-A and correlate these parameters with visual field indices in MS patients with and without a history of ON. By analyzing inter-eye differences and comparing with MS patients, the research seeks to clarify whether OCT-A metrics can serve as reliable biomarkers for visual dysfunction and disease progression in MS. Understanding this correlation could improve early detection of neuroretinal damage, guide monitoring of disease activity, and potentially inform therapeutic strategies.

Inclusion criteria

• Diagnosis of relapsing-remitting multiple sclerosis (RR-MS) or other MS subtypes confirmed by established neurological criteria. .Ability to undergo OCTA imaging and visual field testing. .Visual acuity sufficient to perform reliable visual field testing.
• Absence of other ocular diseases affecting the retina or optic nerve (e.g., diabetic retinopathy, glaucoma)

Exclusion criteria

.History of ocular diseases unrelated to MS that could confound OCTA or visual field results.

.Recent optic neuritis episode within a defined period (often 3-6 months) to avoid acute inflammation effects.

.Media opacities preventing quality OCTA imaging. .Systemic diseases that may affect retinal vasculature (e.g., uncontrolled hypertension, diabetes).

.Poor cooperation or inability to complete visual field testing reliably