Paramagnetic Rim Lesions Are Associated With Trans-Synaptic Degeneration of the Visual Pathway in Multiple Sclerosis.

PwMS had higher rTSD than healthy (p = 0.006) and non-multiple sclerosis controls (p = 0.009).

African American race (p = 0.02) and longer disease duration (p = 0.005) were associated with higher baseline rTSD.

Longitudinally, each unit/year progression in rTSD was associated with a -0.07 dB/year decline in hemifield sensitivity (p = 0.005) and a 10.8-fold increase in the odds of expanded disability status scale score progression (p = 0.022).

Higher body mass index was associated with faster rTSD progression longitudinally (p = 0.02).