Researchers Discover Altered Inner Plexiform Layers in MS

During ARVO earlier in May, investigators from Massachusetts Eye and Ear presented an approach to evaluate multiple sclerosis (MS) for optic neuritis. Multiple sclerosis is a chronic autoimmune disease in which people can commonly develop optic neuritis. Using a combination of standard OCT findings and examination of the inner plexiform layer, clinicians may get a better understanding of the disease state. These images from another study show representative retina scans of an MS patient with optic neuritis (MSON) and their unaffected fellow eye (MSFE) as well as a healthy control (HC) for comparison. Photo: Hu H, et al. IOVS. 2019(60):4257-4269. Click image to enlarge. “Synaptic involvement is implicated in multiple sclerosis, yet commonly used OCT metrics, such as the retinal nerve fiber layer and ganglion cell complex, primarily capture axonal loss,” they explained in their ARVO abstract. “The inner plexiform layer (IPL), composed of five synaptic sublayers, may reveal microstructural changes that thickness metrics miss.”The IPL was examined in 49 MS patients (92 eyes) and 59 control subjects (109 eyes). Following examination, patients with MS had brighter hyporeflective IPL sublayers, reduced contrast and fewer IPL segments with five sublayers compared to the control. Interestingly, brighter hyporeflectivity was found to be associated with longer disease duration. In regard to optic neuritis, these differences were found in eyes that presented without the retinal condition.In addition to the inner plexiform layer changes discovered, researchers assessed the discrimination ability of inner plexiform layer metrics and standard OCT metrics. They found an area under the curve (AUC) of 0.81 when analyzing the IPL. This exceeded retinal nerve fiber layer and ganglion cell complex metrics (AUC=0.67 and 0.65). By adding all three metrics together, the AUC improved (0.002-0.014)“We found that people with MS had a more blurred, disorganized pattern in this layer, even when they had no history of optic neuritis, and that these changes separated MS eyes from healthy eyes better than standard OCT measurements,” concluded the researchers. “As imaging technology improves, this type of retinal analysis could become a simple clinic tool to track synaptic health, complement MRI, and help guide earlier and more precise treatment decisions in MS.”Original abstract ©2026 Association for Research in Vision and Ophthalmology. Click here for the source. Emfietzoglou M, Correa VSMC, Sakuno G, et al. Inner plexiform layer microstructure is altered in multiple sclerosis and improves discrimination from healthy controls compared to RNFL and GCC. ARVO 2026 annual meeting. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.