The clinical relevance of hyper-reflective foci in the inner retina at the diagnosis of multiple sclerosis.

BACKGROUND

Hyper-Reflective foci (HRF) increased in the inner retina (IR) of patients with Multiple Sclerosis (pwMS).

OBJECTIVE

To evaluate the risk of therapeutic failure, based on HRF count at baseline.

METHODS

Fifty-seven pwMS were included in this retrospective, cohort, single-centre study. All patients were enrolled at clinical onset and were treatment-naive, with no evidence of optic nerve involvement. Patient were divided at baseline based on the MS treatment in platform-therapy pwMS (PTpwMS) and as High efficacy therapy pwMS (HETpwMS). Then, all PTpwMS were followed up (87.6±31.2 months) to evaluate the time to therapeutic switch for lack of efficacy on outcomes. HRF count was expressed as the sum of both eyes in Ganglion Cell-Inner Plexiform Layer (GCIP), Inner Nuclear Layer (INL) and Inner Retina (IR, GCIP + INL).

RESULTS

Survival analysis confirmed an increased risk of therapeutic switch in those patients with a higher HRF-INL count (Log-Rank p < 0.0001, H.R. 7.9, 95%CI 2.6-24.5). PTpwMS switching during the follow up had significantly higher HRF count in INL compared to not-switching (45.80 ± 10.32vs 31.75 ± 6.27, p < 0.05).

CONCLUSIONS

HRF might be a useful marker to predict the risk of acute demyelination in MS and might give help Neurologist in therapeutic decision.