## 5 Results  
Forty-six patients (27 females, 19 males, mean age of 36.9 \(\pm\) 1.8 years, range 22-69) with average disease durations of 7.2 \(\pm\) 0.9 years were included in this study. The baseline ophthalmological characteristics of the whole sample are reported in Table 1, while baseline OCT parameters are summarized in Table 2. \begin{table}
\begin{tabular}{c c} \hline
**Parameter** & **Mean (SEM)** \\ \hline
**BCVA (logMar)** & 0.18 (0.02) \\
**LCLA 5\% (letters)** & 37.36 (1.24) \\
**LCLA 2.5\% (letters)** & 26.85 (1.47) \\
**LCLA 1.25\% (letters)** & 15.14 (1.47) \\
**VF-MD (dB)** & \(-\)4.37 (0.6) \\ \hline \end{tabular}
\end{table} 
Table 1: Ocular findings in relapsing-remitting multiple sclerosis (RR-MS) patients at baseline. Longitudinal analysis did not show statistically significant progression of the EDSS (average annual rate: \(-0.14\pm 0.1\); \(p=0.157\)). No patients progressed from RR-MS to secondary progressive MS or had relapses, including ON, during the follow-up. VA parameters did not show significant progression during the follow-up. In fact, the BCVA (expressed in logMar) showed an annual rate of \(-0.02\pm 0.01\), which indicates an improvement in 1 ETDRS letter, which is not clinically significant. The 5% LCLA did not have a significant average annual progression rate (\(+2.33\pm 1.23\) letters). However, the 2.5% LCLA and 1.25% LCLA showed slight improvements, though not clinically significant, with an average annual rate of \(+3.48\pm 0.45\) letters and \(+0.52\pm 1\) letters, respectively. In the entire cohort, for the visual field-mean deviation (VF-MD), the progression rate per year was \(-0.14\pm 0.17\) dB, which was not statistically significant (\(p=0.433\)). The OCT assessment did not show cases of ME related to fingolimod therapy. However, by analyzing the macular parameters in the whole cohort, we observed a statistically significant reduction in CRT, with an average annual rate of \(-1.81\pm 0.41\) um (\(p<0.001\)), and in TMV, with an average annual rate of \(-0.1\pm 0.01\) mm\({}^{3}\) (\(p<0.001\)). Furthermore, there was a statistically significant reduction in pRNFL-T, with an average rate of \(-3.3\pm 0.51\) um/year (\(p<0.001\)). Finally, the average RNFL 4 quadrants thickness in each sector also significantly decreased (\(p<0.05\)) over the follow-up, compared to the baseline. The average annual progression rates of the selected OCT parameters are summarized in Table 3.  
Moreover, we analyzed the annual progression rates in the two subgroups, and we observed that the ON+ patients showed, for most OCT parameters, a statistically faster progression rate during the follow-up, compared with ON- patients (\(p<0.05\)) (Figures 1 and 2) (Table 4). \begin{table}
\begin{tabular}{c c} \hline \hline
**Parameter** & **Mean (SEM)** \\ \hline
**TMV (mm\({}^{3}\))** & 9.84 (0.07) \\
**CRT (\(\upmu\)m)** & 254.44 (2.5) \\
**pRNFL-T (\(\upmu\)m)** & 118.65 (3.27) \\ _Superior quadrant (\(\upmu\)m)_ & 106.55 (2.14) \\ _Nasal quadrant (\(\upmu\)m)_ & 66.01 (1.52) \\ _Inferior quadrant (\(\upmu\)m)_ & 109.84 (2.35) \\ _Temporal quadrant (\(\upmu\)m)_ & 54.69 (1.47) \\
**NRR-T (\(\upmu\)m)** & 432.4 (17.78) \\ \hline \hline \end{tabular}  
* OCT = optical coherence tomography; TMV = total macular volume; CRT = central retinal thickness; pRNFL-T = peripapillary retinal nerve fiber layer thickness; NRR-T = neuroretinal rim thickness; \(\upmu\)m = micrometers; mm\({}^{3}\) = cubic millimeters.  
\end{table} 
Table 2: Optical coherence tomography (OCT) parameters in RR-MS patients at baseline.