RNFL changes predict reduced quality of life in MS

This study found that patients with relapsing-remitting multiple sclerosis (MS) who had progressive axonal loss seen in retinal nerve fiber layer (RNFL) measurements had a lower quality of life and more functional disability.

Subjects were 54 patients with relapsing-remitting MS who filled out a 54-item Multiple Sclerosis Quality of Life (MSQOL-54) questionnaire and Expanded Disability Status Scale (EDSS) evaluation, in addition to undergoing complete neuro-ophthalmologic examination, including visual field testing and RNFL measurements using Cirrus and Spectralis OCT and visual evoked potentials (VEP). All patients were re-evaluated at 12, 24 and 36 months.

The authors found that RNFL thickness results from the baseline evaluation were significantly different from those at three years (P ≤ 0.05), but there were no differences in functional measures (visual acuity, contrast sensitivity, color vision, visual field and VEP). A reduced MSQOL-54 score was associated with an increase in EDSS score and a decrease in both functional and structural parameters. Patients with longer MS duration presented with a lower MSQOL-54 score, indicating a reduction in QOL.

The authors say the study's findings indicate that structural evaluation of RNFL using OCT provides a good biomarker for the prediction of changes in quality of life in patients with MS and is better than visual function evaluation using VEPs, visual acuity, contrast sensitivity, color vision or visual field assessment.