The role of optical coherence tomography in the assessment of axonal damage in autoimmune lesions of the optic nerve

The purpose of the study was to comparatively analyze optical coherence tomography (OCT) data from patients with neuromyelitis optica (NMOSD) and optic neuritis in multiple sclerosis (MS-ON) to identify structural differences and refine diagnostic criteria. Material and methods. A comprehensive ophthalmological and neuroimaging examination, including OCT with assessment of retinal nerve fiber layer thickness (RNFLT), macular area, and choroid, was performed in 26 patients (46 eyes). Results. Patients in both study groups showed a significant decrease in RNFLT compared to the controls (p < 0.01), with the most pronounced changes noted in the NMOSD-ON group, especially in the temporal quadrant. The incidence of macular microcystic edema was 30.7% in patients with NMOSD-ON and 11.5% in patients with MS-ON (p = 0.02). Subfoveal choroidal thickness did not differ significantly between the groups (p > 0.05). Conclusion. OCT results confirm that NMOSD-associated optic neuritis is characterized by more pronounced axonal degeneration and structural changes. Integration of neuroimaging and clinical data improves the accuracy of differential diagnosis and can serve as a basis for developing personalized approaches to treating and monitoring patients with inflammatory optic nerve lesions.

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