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Cross-sectionalBiomedicines · 2026

Silent Retinal Neurodegeneration in Multiple Sclerosis: Structural Evidence from Clinically Unaffected Eyes Using Swept-Source OCT and OCT Angiography-A Cross-Sectional, Observational Study.

Katarina Katanić Pasovski, Ivana Todorović, Viktor Pasovski … Evica Dinčić

OphthalmologyCross-sectional

Fellow eyes after one-sided optic neuritis show more retinal thinning than never-affected eyes

Silent Retinal Neurodegeneration in Multiple Sclerosis: Structural Evidence from Clinically Unaffected Eyes Using Swept-Source OCT and OCT Angiography-A Cross-Sectional, Observational Study.

Katarina Katanić Pasovski … Evica Dinčić

Biomedicines · 2026

Background

Retinal optical coherence tomography (optical coherence tomography) has emerged as a sensitive biomarker of neurodegeneration in multiple sclerosis (multiple sclerosis), yet eyes without overt optic neuritis (optic neuritis) are routinely pooled as "clinically unaffected" despite their heterogeneous histories.

Methods

In this cross-sectional, single-center study, 126 clinically unaffected multiple sclerosis eyes-96 never-optic neuritis eyes and 30 fellow eyes after unilateral optic neuritis-were compared with 118 healthy control eyes.

n = 126 clinically unaffected MS eyes

Results

fellow eyes had thinner retinal nerve cells than never-affected eyes

66.14µm

Controls

62.08µm

Never-ON eyes

58.03µm

Fellow eyes

More results

Despite preserved visual acuity, both never-optic neuritis and fellow eyes showed structural retinal thinning relative to controls.

After false discovery rate correction, OCT angiography parameters did not differ significantly between groups.

“

Conclusion · 1 of 3

Clinically unaffected eyes in multiple sclerosis are not structurally normal, and fellow eyes after unilateral optic neuritis carry a greater burden of silent retinal damage than never-optic neuritis eyes.

Conclusion · 2 of 3

These two phenotypes should be analyzed separately in multiple sclerosis imaging research.

Conclusion · 3 of 3

Structural optical coherence tomography measures, particularly ganglion cell-inner plexiform layer thickness, appear more sensitive than microvascular indices for detecting subclinical retinal involvement.

Post

Silent Retinal Neurodegeneration in Multiple Sclerosis: Structural Evidence from Clinically Unaffected Eyes Using Swept-Source OCT and OCT Angiography-A Cross-Sectional, Observational Study.

Fellow eyes after one-sided optic neuritis show more retinal thinning than never-affected eyes

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