OCT to Assess Risk of Progression of Multiple Sclerosis: A Report by the American Academy of Ophthalmology.

Authors

Heather E Moss, Isdin Oke, John J Chen, Marc J Dinkin, Mays A El-Dairi, Eric D Gaier, Aubrey L Gilbert, Peter W MacIntosh, Stacy L Pineles, Gena Heidary

Published in

Ophthalmology. Oct 21, 2026. Epub Oct 21, 2026.

Abstract

To review the current published literature on the utility of OCT of the retina in peripapillary and macular regions to predict or assess risk of disease activity in adult patients with multiple sclerosis (MS) and MS precursors (radiologically isolated syndrome and clinically isolated syndrome).
A literature search of the PubMed database was last performed in September 2025. Articles were limited to original research in the English language that included adult patients. The search yielded 275 articles that were examined in abstract form to exclude reviews, and 71 were reviewed in full text. Twenty-one articles were selected for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist.
Two studies were rated level I, 8 studies were rated level II, and 11 studies were rated level III. Baseline measurements (lower thickness, faster thickness decline, and larger interocular thickness differences) of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (GC-IPL) from OCT scans in patients with MS and precursors of MS were associated with future progression of MS as measured by disability, clinical relapses, and magnetic resonance imaging (MRI) changes. Multiple variable models support the independent association of OCT metrics and MS progression.
Evidence supports the development of OCT-derived pRNFL and macular GC-IPL thickness measurements as biomarkers for future progression of MS in patients with MS or MS precursor syndromes. Future work is needed to improve generalizability by studying demographically heterogeneous cohorts and should include determining the comparability of metrics obtained from different OCT manufacturers' hardware and software. Future research is also needed to guide interpretation of OCT in the context of other predictors of future disease activity such as MRI.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

PMID:
42905039
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.

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