Optical coherence tomography findings in multiple system atrophy: insights into disease diagnosis, clinical correlations, and dopaminergic degeneration.

BACKGROUND

Differentiating multiple system atrophy (MSA) from Parkinson’s disease (PD) and progressive supranuclear palsy (PSP) remains challenging. Retinal optical coherence tomography (OCT) offers noninvasive insights into neurodegeneration but remains underexplored in MSA.

OBJECTIVES

To compare OCT-derived retinal parameters in MSA, PD, PSP, and healthy controls (HCs), evaluate associations with clinical features and dopaminergic degeneration.

METHODS

We enrolled 21 MSA, 22 PD, and 23 PSP patients, plus 23 HCs. OCT measured macular and retinal nerve fiber layer thicknesses. Clinical assessments and 11C-CFT PET evaluated motor/non-motor symptoms and presynaptic dopaminergic integrity.

RESULTS

MSA exhibited significant retinal differences compared to HCs and PSP, with subtler distinctions observed when compared to PD. Retinal thickness correlated with axial motor impairments, dysphagia, and dopaminergic uptake in the caudate nucleus.

CONCLUSIONS

OCT parameters may aid in differentiating MSA from other parkinsonian syndromes and serve as a indicator linked to disease severity and dopaminergic dysfunction.