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Meta-analysisJournal of neuroimmunology · 2026

A systematic review and meta-analysis of OCT-based ophthalmic changes in amyotrophic lateral sclerosis.

Asmar Ahsan, Ju-Chi Ou, Pritha Majumder … Chi-Chen Sarah Huang

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OphthalmologyMeta-analysis

Retinal nerve fiber layer is thinner in amyotrophic lateral sclerosis patients than in healthy controls.

A systematic review and meta-analysis of OCT-based ophthalmic changes in amyotrophic lateral sclerosis.

Asmar Ahsan … Chi-Chen Sarah Huang

Journal of neuroimmunology · 2026

Background

Amyotrophic lateral sclerosis (amyotrophic lateral sclerosis) is a progressive neurodegenerative disease marked by motor decline and respiratory failure.

Methods

A systematic literature search was conducted across PubMed, EMBASE, and Cochrane databases for studies published between 2010 and May 2025.

n = 17 studies

Results

lower means thinner nerve fiber layer at the back of the eye

SMD -0.29 (95% CI -0.52 to -0.07)

CI excludes the null - significant

More results

Upon applying a Design Effect variance inflation model to address fellow-eye non-independence, the pooled estimate remained robustly significant across a conservative range of intraclass correlations (SMD ranged from -0.256 to -0.249).

More results

Subgroup analyses revealed that retinal nerve fibre layer thinning was particularly pronounced in spinal-onset amyotrophic lateral sclerosis (SMD = -0.54, 95% CI: (-0.98, -0.10).

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Conclusion

This meta-analysis demonstrates significant bilateral retinal nerve fibre layer thinning in amyotrophic lateral sclerosis, with relative preservation of the Inner Nuclear Layer and Ganglion Cell Layer - Inner Plexiform Layer, supporting retinal neurodegeneration as a feature of this multisystem disorder.

Post

A systematic review and meta-analysis of OCT-based ophthalmic changes in amyotrophic lateral sclerosis.

Retinal nerve fiber layer is thinner in amyotrophic lateral sclerosis patients than in healthy controls.

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