Up to 10 per cent of patients with MS experience early disease onset – before they are 18.

The retina is a layered structure within the eye. The retinal nerve fibre layer is the cellular layer within the retina that generates the optic nerve. The macula is a small portion of the retina’s nerve cells, which are very sensitive to light and colours.

If the macula is damaged and its volume reduced, sight is irreversibly damaged.

Optical coherence tomography (OCT) is a new non-invasive way of assessing retinal nerve fibre layer thickness and macular volume.

These two parameters seem to correlate with neurodegeneration in MS patients, and may be useful to differentiate axonal and neuronal damage in the retina of patients with a history of early onset of MS.


The European Journal of Neurology reported research carried out at two German academic MS centres. This involved 32 healthy controls, 36 people with early-onset MS, and 58 people with later onset MS.

The researchers looked for a link between retinal nerve fibre layer or macula damage in
early-onset patients compared with patients with later onset and healthy controls.

Their findings showed OCT documenting early occurring axonal and neuronal damage in the retina of early-onset MS patients. This suggests immunotherapy should be started as early as possible in MS, in order to prevent irreversible damage

These findings suggest that OCT may be a good way to monitor the efficacy of both immunoprotective and neuroprotective therapies.

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