Clinical Significance of Visual System Modeling for Multiple Sclerosis Research: Shiv Saidha, MBBCh

WATCH TIME: 6 minutes

"We're able to assess the clinical function through the testing of visual function. Not just high contrast visual acuity, but also low contrast visual acuity. We know that contrast sensitivity and low contrast visual impairment is very common in patients with MS."

Neurodegeneration is a primary contributor to disability in patients living with multiple sclerosis (MS). By utilizing optical coherence tomography (OCT), inner retinal atrophy can provide an objective measure that mirrors brain atrophy and the accrual of disability in MS. Overall, retinal pathology in MS reflects broader aspects of progression in the disease. Despite the growing recognition of OCT's utility in assessing neurodegeneration in MS, there remains limited research on examining how various oral disease-modifying therapies, such as dimethyl fumarate, fingolimod, and teriflunomide, differentially impact retinal atrophy.

In a recent real-world observational study, findings showed that patients with relapsing MS (RMS) treated with dimethyl fumarate and fingolimod had slower rates of ganglion cell-inner plexiform layer (GCIPL) atrophy compared with patients with RMS treated with teriflunomide.¹ The results from this cohort suggest dimethyl fumarate and fingolimod are effective therapies for RMS, both from a clinical and imaging biomarker perspective. These findings, presented at the 2024 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 29 to March 2, by senior author Shiv Saidha, MBBCh, professor of neurology at Johns Hopkins Medicine, and colleagues, suggest that dimethyl fumarate and fingolimod may be effective therapies for RMS.

At the forum, Saidha also presented a talk on the visual system as a model for neuroprotection trials. Following the session, Saidha sat down with NeurologyLive® to discuss the interplay between MS and the visual system, and why it is significant. He also talked about the specific measurements and techniques that are utilized to assess the integrity of the optic nerve and detect neurodegeneration in patients with MS. Additionally, Saidha explained why there is a growing interest in developing tools for neuroprotection in MS research, and the challenges that exist in utilizing conventional MRI techniques for this purpose.

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REFERENCES
1. Ezzedin O, McCormack B, Duval A, et al. In-Vivo Investigation of the Modulation of Retinal Atrophy by Oral Disease Modifying Therapies in Relapsing Multiple Sclerosis: A Prospective Study. Presented at ACTRIMS Forum 2024; February 29 to March 2; West Palm Beach, Florida. P080.