Optical Coherence Tomography (OCT) is a fast, non-invasive tool utilized to quantify retinal thickness and volume. It is thought that men experience a more aggressive course of MS than women with faster accumulation of disability.
To compare the gender influence on retinal volumes and thickness of patients in the early stages of multiple sclerosis (MS).
Sixty patients in the early stages of MS (≤3 years since symptom onset) underwent OCT exams and were included in this single-center, retrospective, cross-sectional analysis. Patients were divided into 2 groups: 22 men (mean age±SD: 39.95±10.95; mean disease duration±SD: 0.98±1.15) and 38 women (mean age±SD: 38.21±11.52; mean disease duration±SD: 1.45±0.97). All OCT scans were performed to quantify peripapillary retinal nerve fiber layer (pRNFL) thickness. The pRNFL was then separated into four quadrants: superior (S), inferior (I), nasal (N), and temporal (T). Fully automated, intra-retinal segmentation was performed to measure the volume of the macula: total macular (TMV), retinal nerve fiber (RNFL), ganglion cell + inner plexiform (GCIP), and photoreceptor (PR). A multiple analysis of covariance (MANCOVA) with gender as the independent variable and OCT parameters as dependent variables was used to analyze our data. Age and disease duration were included as covariates (SPSS v26).
TMV and PR retinal volumes were found to be statistically lower in women than men (p=0.042 and 0.008 respectively). RNFL volume was trending lower in women than men, but did not reach significance (p=0.090). There was no significance noted in the other retinal volumes or thickness between the two groups.
Our results indicate there may be more prominent retinal volume loss in women than men in the early stages of MS. OCT should be utilized as a surrogate tool to monitor early disease progression, especially in the female population. Future longitudinal studies with larger samples should be conducted to confirm these findings.