Parafoveal OCT Scans Show Promise as Biomarker of MS Progression

Anatomical variations of parafoveal retinal layer thickness measured using optical coherence tomography (OCT) were associated with clinical outcomes in individuals with multiple sclerosis (MS) according to study results presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2025.

The cross-sectional study included 214 people with MS and 57 age- and sex-matched healthy controls (HCs). All participants underwent clinical assessment and OCT evaluations to measure macular, parafoveal, and peri-papillary thickness of the retinal layers. Researchers used logistic and linear regression models to assess the association between the OCT parameters and various clinical outcomes.

Key findings from the study include the following:

• People with MS had significantly thinner parafoveal retinal nerve fiber layer (RNFL) (P=.023), ganglion cell layer (GCL) (P<.001), and ganglion cell-inner plexiform layer (P<.001) thickness levels compared with HCs.
• Parafoveal GCL thickness was the strongest predictor of optic neuritis occurrence (odds ratio [OR], .84; P<.001) and progressive MS status (OR, .92; P<.001).
• The Expanded Disability Status Scale (EDSS) scores of people with MS were associated with parafoveal GCL (standardized β, -.472; P<.001) and RNLF thickness (standardized β, .187; P=.021).

Previous studies assessing the use of OCT to assess clinical MS outcomes have focused on macular and peri-papillary regions. This study highlights that parafoveal OCT segmentation may assist in the detection of neuroinflammatory and neurodegenerative processes associated with MS.