EAN 2023 | OCT-angiography: assessing optic nerve vascularization in MS patients
Celia Oreja-Guevara, MD, PhD, University Hospital San Carlos, Madrid, Spain, discusses her hospital’s work with OCT-angiography, a non-invasive and contrast-free imaging technique, which offers significant advantages over traditional angiography. OCT-angiography enables the assessment of vascularization around the optic nerve, an area of frequent inflammation in multiple sclerosis. The evaluation of capillary density helps differentiate patients with optic nerve inflammation from those without. Patients with optic neuritis exhibit reduced capillary vessel density around their retina, indicating potential damage. This research not only aids in diagnosis but can potentially assist in treatments to repair inflammation-induced damage. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.
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Transcript (edited for clarity)
What we are doing in our hospital, our team is working a lot with optical coherence tomography, and now we are working with the optical coherence tomography angiography. So, what we say OCT-angiography. That is an advantage because the angiography normally when the ophthalmologists are doing the angiography you need to put in contrast and that is an invasive technique. With the OCT-angiography we can look at the optic nerve, we can look at the retina, but we don’t need to add the contrast, so that is not an invasive technique...
What we are doing in our hospital, our team is working a lot with optical coherence tomography, and now we are working with the optical coherence tomography angiography. So, what we say OCT-angiography. That is an advantage because the angiography normally when the ophthalmologists are doing the angiography you need to put in contrast and that is an invasive technique. With the OCT-angiography we can look at the optic nerve, we can look at the retina, but we don’t need to add the contrast, so that is not an invasive technique. It is very easy to do so that now with the OCT we are looking at the optic nerve and we are looking at the at the different layers of the retina, and now with the OCT-angiography we are looking at the vessels, at the vascularization around the optic nerve.
That is important because we know in multiple sclerosis, around the around the vessels, there are always this a lot of inflammation and a lot of lymphocytes. So that we can look how it is around the optic nerve. With this technique we can see two different things. We can see the superficial capillary plexus and the deep capillary plexus. In both of them we can look at the density of the vessels, and we can look at the place without vessels. So we have done work and we have two different groups, patients with optic neuritis, so with an inflammation of the optic nerve, and patients without optic neuritis, without any inflammation of the optic nerve. We have compared and we have seen that the patients with the optic nerve alteration with optic neuritis, they have less capillary density. It means they have less vessels because probably they have a more inflammation and the vessels are probably destroyed. We don’t know really the reasons. They have less density of vessels, and they have the area of without vessels that is getting bigger and bigger. So that it means for one reason, we don’t know why, the patients with optic neuritis, they lost vessels and probably because they have axonal damage and they are losing some cells. And in contrast, on the other side, the patients without optic neuritis, they have a normal vessel density and they have a normal avascular area. So that I think that is important to differentiate patients, that they have an optic neuritis in the past and others that they don’t have, because sometimes the patients they cannot remember.
And the other thing that is important, we think that it’s important as biomarker of the prognostic. Who will be the patients with the optic neuritis. And I think it could be perhaps used to monitor some new treatments such as the BTK or some new treatments that they can do reparation, that they can do remyelination, and we can monitor these treatments.
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