Additive value of Retinal-and Serum-Biomarkers to predict disability inMultiple Sclerosis

Abstract

Aims To investigate the additive value of OCT and serum biomarkers to prognosticate disability worsening in patients with multiple sclerosis (pwMS). Methods PwMS from the Swiss MS Cohort Study (SMSC) with Q1); (2) low Z score and thin OCT (=Q3) and thin OCT. Results 257 patients were included (median age at (BL): 49 y, 63% female, median FU-time: 2.2 y). Both pRNFL (beta = -0.005, p < 0.001) and GCIPL (beta = -0.002, p < 0.001) at BL were associated with EDSS increase over time. A 10 mum GCIPL loss increased the EDSS trajectory by 0.02. INL showed no significant impact (beta = -0.17, p = 0.136). sGFAP showed a trend (beta = 0.01, p = 0.050), while sNfL. Z scores were not prognostic (beta < 0.001, p = 0.913). Based on these results, sGFAP was combined with GCIPL for stratification. Compared to group 1 (low sGFAP and thick GCIPL, n = 141), patients in group 2 (low sGFAP and thin GCIPL, n = 43) exhibited a steeper increase in EDSS over time (beta = 0.052, p = 0.007), while group 3 (high sGFAP and thin GCIPL, n = 19) showed the steepest EDSS slope (beta = 0.102, p = 0.0001). Conclusions GCIPL as measure of neuronal loss and sGFAP as marker of astrocytic activation or injury in MS showed additive effects on EDSS worsening over time. Our findings highlight the potential of combining retinal and serum biomarkers for disability prediction and stratification of pwMS.5.