Friedemann Paul, MD, Charité - Universitätsmedizin Berlin, Berlin, Germany discusses the potential of optical coherence tomography (OCT) in multiple sclerosis (MS). OCT is a very sensitive tool that can measure and monitor retinal neurodegeneration, axonal damage, and loss of retinal ganglion cells. Indeed, cross-sectional and longitudinal studies have shown progressive retinal tissue loss in MS, both subsequent to a clinical attack of optic neuritis but also in eyes not previously affected by optic neuritis. At the moment, MRI surveillance and clinical data of patients are used to make treatment decisions; how to incorporate OCT into the treatment algorithm as an additional tool is not yet clear. Artificial intelligence could also be used to monitor disease course and improve differential diagnosis through retinal imaging i.e., distinguishing MS with optic neuritis versus other causes of optical neuritis such as NMOSD or MOGAD. This interview was conducted during the 2022 World Congress on Controversies in Neurology (CONy) meeting.
