Peripapillary Vessel Density as Early Biomarker in Multiple Sclerosis

Background:To evaluate retinal vessel density (VD) in macular and in peripapillaryregions in patients with recent onset of multiple sclerosis, at initial demyelinating event(IDE) and in matched relapsing-remitting multiple sclerosis (RRMS) patients.Methods:We evaluated VD in superficial capillary plexus, deep capillary plexus,choriocapillaris and radial peripapillary capillary plexus in IDE, RRMS patients and inmatched healthy controls (HCs) through Optical Coherence Tomography Angiography(OCT-A). Clinical history, including history of optic neuritis, Expanded Disability Statusscale and disease duration of patients were collected.Results:Thirty patients (20 with IDE and 10 with RRMS) and 15 HCs were enrolled. IDEpatients showed a lower VD in radial peripapillary capillary plexus compared with controls(coeff.β= −3.578;p=0.002). RRMS patients displayed a lower VD in both superficialcapillary plexus and radial peripapillary capillary plexus compared with HCs (coeff.β=−4.955;p=0.002, and coeff.β= −7.446;p<0.001, respectively). Furthermore, RRMSpatients showed a decreased VD in radial peripapillary capillary plexus compared withIDE patients (coeff.β= −3.868;p=0.003).Conclusions:Peripapillary region vessel density reduction, revealed through OCT-A,might be considered as an early event in MS, and might be relevant as a biomarker ofdisease pathology.