Optical Coherence Tomography – A New Monitoring Tool for Multiple Sclerosis?

Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system (CNS) with inflammatory demyelinating lesions and neuronal loss that is clinically characterised by unpredictable clinical relapses, remissions and progression of disability over time. Damage occurs to the myelin sheath that surrounds and protects nerve cells; this slows down or blocks messages between the brain and the body, leading to the symptoms of MS. The disease usually begins with one or more clinically isolated syndrome (CIS) leading to a relapsing– remitting phase (RRMS) that is accompanied by a varying degree of impairment. After 10–15 years, approximately 50% of these patients advance to the secondary progressive form of the disease, which is characterised by a slow but progressive decline in performance with or without superimposed relapses. Approximately 10–15% of MS patients show progression from the onset (primary progressive MS [PPMS]). Symptoms are highly heterogeneous from one patient to another. More recently, our attention has been focused on the nonphysical symptoms such as fatigue and cognitive symptoms.