Mode
Text Size
Log in / Sign up

Optical coherence tomography shows significantly reduced retinal measurements in neuromyelitis optica spectrum disorder compared to multiple sclerosisRetinal Scans Show Distinct Differences Between MS and NMOSD

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note that OCT measurements are significantly lower in PwNMOSD than PwMS, particularly in eyes with a history of optic neuritis.

This systematic review and meta-analysis evaluates the utility of optical coherence tomography (OCT) measurements in distinguishing between patients with multiple sclerosis (PwMS) and neuromyelitis optica spectrum disorder (PwNMOSD). The analysis included 3520 PwMS and 1463 PwNMOSD.

The meta-analysis found that PwNMOSD demonstrated significantly lower retinal measurements across all primary metrics compared to PwMS. Specifically, peripapillary retinal nerve fiber layer (pRNFL) thickness was significantly thinner in PwNMOSD (SMD = 0.61; 95% CI: 0.44-0.79), with the largest effect observed in eyes with a history of optic neuritis (SMD = 0.98; 95% CI: 0.73-1.22). Additionally, PwNMOSD showed significantly reduced total foveal volume (SMD = 1.15), total macular volume (SMD = 0.52), and macular ganglion cell-inner plexiform layer (mGCIPL) thickness (SMD = 0.47) compared to PwMS.

The authors noted limitations including the need for standardized imaging protocols and established diagnostic criteria. While OCT measurements are consistently reduced in PwNMOSD, they cannot currently be used as a definitive diagnostic tool for NMOSD over MS due to these requirements. The findings suggest that while OCT provides evidence of structural differences between the two conditions, further standardization is necessary before clinical implementation.

How this fits prior evidence

This meta-analysis addresses a gap in identifying objective imaging biomarkers to differentiate multiple sclerosis from neuromyelitis optica spectrum disorder. While previous coverage has established serum neurofilament light chain as a robust biomarker of recent neuroaxonal injury and identified factors like aging and diabetes as modifiers of risk and phenotype in these neurological disorders, this study provides specific evidence regarding retinal structural differences between MS and NMOSD.

Researchers analyzed data from over 5,000 patients to compare how Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD) affect the eyes. They used a specialized imaging technique called Optical Coherence Tomography (OCT) to measure various layers of the retina.

The study found that people with NMOSD had significantly thinner retinal nerve fiber layers and lower macular volumes compared to those with MS. These differences were most noticeable in eyes that had a history of optic neuritis. Specifically, measurements for foveal volume and ganglion cell thickness were consistently lower in the NMOSD group.

While these findings show a clear link between the type of condition and specific eye measurements, the results are not yet enough to use as a definitive diagnostic tool. The researchers noted that more standardized imaging protocols and clearer diagnostic criteria are needed before these scans can be used routinely to tell the two conditions apart.

What this means for you:
Retinal scans show measurable differences between MS and NMOSD, especially in eyes with a history of inflammation.

Common questions

How do eye scans help distinguish between MS and NMOSD?

Eye scans called OCT measure the thickness of the retina. The study found that people with NMOSD had significantly thinner nerve fiber layers and lower macular volumes compared to those with MS. These differences were most pronounced in eyes that had a history of optic neuritis.

Are these eye measurements used to diagnose my condition?

While the study shows clear differences in retinal thickness between MS and NMOSD, it is not yet a definitive diagnostic tool. Experts say more standardized imaging protocols are needed before these scans can be used for official diagnosis.

What specific parts of the eye were affected?

The study measured several areas including the peripapillary retinal nerve fiber layer, total foveal volume, and macular ganglion cell-inner plexiform layer thickness. All three measurements were significantly lower in patients with NMOSD compared to those with MS.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are chronic autoimmune demyelinating diseases of the central nervous system (CNS) that frequently present with overlapping features, including optic neuritis (ON). This study aimed to evaluate differences in retinal measurements obtained via optical coherence tomography (OCT) between people with multiple sclerosis (PwMS) and neuromyelitis optica spectrum disorder (PwNMOSD). METHODS: The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were systematically searched up to February 22, 2025, to identify relevant studies investigating retinal changes assessed by OCT in PwMS and PwNMOSD. A meta-analysis was conducted using R software version 4.4.0, applying a random-effects model to calculate pooled standardized mean differences (SMD) for OCT parameters between PwMS and PwNMOSD, as well as between eyes with and without a history of ON. RESULTS: This systematic review and meta-analysis included 60 studies with 3520 PwMS and 1463 PwNMOSD. OCT measurements differed significantly between PwNMOSD and PwMS, especially in ON-affected eyes. The most pronounced difference was found in peripapillary retinal nerve fiber layer (pRNFL) thickness, significantly thinner in PwNMOSD than PwMS (SMD = 0.61; 95% CI:0.44-0.79; p < 0.01), with the largest effect in ON eyes (SMD = 0.98; 95% CI:0.73-1.22; p < 0.05). Significant reductions were also seen in total foveal volume (TFV) (SMD = 1.15; p < 0.01), total macular volume (TMV) (SMD = 0.52; p < 0.01), and macular ganglion cell-inner plexiform layer (mGCIPL) thickness (SMD = 0.47; p < 0.01). CONCLUSION: OCT measurements, including pRNFL, mGCIPL, TFV, and TMV, are consistently reduced in PwNMOSD compared to PwMS, particularly in ON-affected eyes. Further studies should standardize imaging protocols and establish diagnostic criteria.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.