Abstract
Northern Ireland has one of the highest multiple sclerosis (MS) prevalence rates in the world. Multiple sclerosis is a progressive neurodegenerative disease of the central nervous system (CNS). The CNS comprises the brain, spinal cord, optic nerve and neurosensory retina, with overlapping neuronal and vascular similarities. Vision is reported to be one of the most important sensory functions for patients to preserve during the disease. As 60 - 80% of patients with MS will experience some form of ocular pathology during their disease course, it is crucial to understand the pathological changes occurring. For this reason, the Belfast Eye and Multiple Sclerosis (BEAMS) study was constructed.The BEAMS study was a cross-sectional single-centre pilot study which explored the feasibility of a wide range of retinal imaging devices with patients with MS. We investigated a range of structural and functional measurements using novel and conventional imaging modalities. These included habitual visual acuity, contrast sensitivity (CS), fundus photography, optical coherence tomography (OCT), OCT-angiography, adaptive optics, and ultra-widefield imaging. Changes in retinal structure and function were compared among patients with MS, eyes with and without a history of optic neuritis, and healthy controls.Results from the BEAMS study replicated several previous findings, showing a thinning of inner retinal layers in patients with MS compared to controls. For the first time, they provided information on the outer retina, including a significant decrease in cone outer-segment density that may underpin functional CS deficits.In conclusion, our work uncovered previously unreported structural and functional changes in the retina that could become biomarkers for MS monitoring. This work also established the foundation for research with larger participant numbers to investigate these changes with disease progression and disability.This thesis is embargoed until 31 July 2029.
| Date of Award | Jul 2024 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Sponsors | Optos plc |
| Supervisor | Imre Lengyel (Supervisor), Denise Fitzgerald (Supervisor) & Tunde Peto (Supervisor) |
Keywords
- Multiple sclerosis
- Retina
- Neurodegeneration
- Adaptive optics
- Optical coherence tomography
- Retinal atrophy
- retinal microvascular
- OCT-A