Using Optical Coherence Tomography to Capture Retinal Microvascular Changes Associated With Multiple Sclerosis
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Observational

Summary: 
      Recent studies have shown that people with multiple sclerosis (MS) who also have diseases
      related to vascular health such as high cholesterol, high blood pressure, diabetes,
      cardiovascular disease, and others, may end up more disabled than people with MS who don't
      have those diseases. This has led to a growing interest in the role of vascular diseases in
      MS since they may provide another avenue of MS treatment. Some also think that vascular
      disease may even be a cause of MS. The back of the eye, the retina, is well-suited to
      studying vascular diseases as blood vessels can be seen even on routine examination of the
      eye by eye doctors. These specialists are used to seeing changes in retinal blood vessels due
      to diseases known to affect the eyes such as glaucoma and diabetes. Sophisticated techniques
      for examining the retina allow for not only visualization of blood vessels, but the rate of
      blood flow through the blood vessels as well. These blood flow changes are thought to come
      before changes in what the blood vessels look like, and so may be able to detect problems
      even earlier than routine examination of the retina by eye doctors. Retinal blood flow has
      never been carefully studied in MS. Given that MS affects the retina due to the late effects
      of inflammation of the optic nerve, or optic neuritis, the investigators expect to see
      altered blood flow in the retinal blood vessels of people with MS compared to healthy control
      subjects. If so, the investigators can then use retinal blood flow as a way to measure
      therapies that target vascular diseases in the MS population and determine if those therapies
      can alter the course of disease.
    

Detailed description: 
      Background data including age, sex, medical history, and neurologic history and status will
      be gathered prior to the study/OCT testing visit. At the single study/testing visit, subjects
      will have their blood pressure and intraocular pressure checked (using numbing drops that
      last 15-20 minutes), undergo vision testing and then have their eyes dilated with standard
      dilating drops. They will then undergo optical coherence tomography testing to determine the
      blood flow of the retinal blood vessels and to take other measurements of the back of the eye
      including thicknesses of the nervous tissue elements of the retina.

      OCT Procedure: The subject will be seated and have their head positioned on a chin rest. They
      will be asked to look at a target (a lighted spot) while a beam of light scans the front part
      of the eye. The light is infrared and will not be visible or cause any sensation. A cotton
      tip swab may be used to help hold the eyelid open temporarily if necessary.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study will enroll both males and females and include all ethnic and racial groups
        through clinical practices. The study will enroll subjects from 18 to 70 years of age.
        Participants older than 70 years are excluded as cooperation with tests may be difficult.
        For similar reasons, participants who have MS and vision worse than 20/200 are excluded.
        The study also excludes those with any eye disease that would interfere with of assessment
        of MS. Otherwise people with any health status are eligible for enrollment. Two groups of
        participants are recruited: people with healthy, normal eyes and people with any type of
        MS.
      
Keywords: Multiple sclerosis; Blood flow; Optical Coherence Tomography; Imaging