Optical Coherence Tomography Measurements Between Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Systematic Review and Meta-Analysis Publisher



Mirmosayyeb O ; Panah Yazdan M ; Tahmasbi Arashlow F ; Vaheb S ; Moases Ghaffary E ; Shaygannejad V ; Fekri M
Source: Multiple Sclerosis and Related Disorders Published:2026

Abstract

Background: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are chronic autoimmune demyelinating diseases of the central nervous system (CNS) that frequently present with overlapping features, including optic neuritis (ON). This study aimed to evaluate differences in retinal measurements obtained via optical coherence tomography (OCT) between people with multiple sclerosis (PwMS) and neuromyelitis optica spectrum disorder (PwNMOSD). Methods: The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were systematically searched up to February 22, 2025, to identify relevant studies investigating retinal changes assessed by OCT in PwMS and PwNMOSD. A meta-analysis was conducted using R software version 4.4.0, applying a random-effects model to calculate pooled standardized mean differences (SMD) for OCT parameters between PwMS and PwNMOSD, as well as between eyes with and without a history of ON. Results: This systematic review and meta-analysis included 60 studies with 3520 PwMS and 1463 PwNMOSD. OCT measurements differed significantly between PwNMOSD and PwMS, especially in ON-affected eyes. The most pronounced difference was found in peripapillary retinal nerve fiber layer (pRNFL) thickness, significantly thinner in PwNMOSD than PwMS (SMD = 0.61; 95% CI:0.44–0.79; p < 0.01), with the largest effect in ON eyes (SMD = 0.98; 95% CI:0.73–1.22; p < 0.05). Significant reductions were also seen in total foveal volume (TFV) (SMD = 1.15; p < 0.01), total macular volume (TMV) (SMD = 0.52; p < 0.01), and macular ganglion cell–inner plexiform layer (mGCIPL) thickness (SMD = 0.47; p < 0.01). Conclusion: OCT measurements, including pRNFL, mGCIPL, TFV, and TMV, are consistently reduced in PwNMOSD compared to PwMS, particularly in ON-affected eyes. Further studies should standardize imaging protocols and establish diagnostic criteria. © 2026 Elsevier B.V.