Diagnosis of multiple sclerosis using optical coherence tomography supported by artificial intelligence

Background: Current procedures for diagnosing multiple sclerosis (MS) present a series of limitations, making it critically important to identify new biomarkers. The aim of the study was to identify new biomarkers for the early diagnosis of MS using spectral-domain optical coherence tomography (OCT) and artificial intelligence. Methods: Spectral domain OCT was performed on 79 patients with relapsing-remitting multiple sclerosis (RRMS) (disease duration <= 2 years, no history of optic neuritis) and on 69 age-matched healthy controls using the posterior pole protocol that incorporates the anatomic Positioning System. Median retinal thickness values in both eyes and inter-eye difference in healthy controls and patients were evaluated by area under the receiver operating characteristic (AUROC) curve analysis in the foveal, parafoveal and perifoveal areas and in the overall area spanned by the three rings. The structures with the greatest discriminant capacity - retinal thickness and inter-eye difference - were used as inputs to a convolutional neural network to assess the diagnostic capability. Results: Analysis of retinal thickness and inter-eye difference in RRMS patients revealed that greatest alteration occurred in the ganglion cell (GCL), inner plexiform (IPL), and inner retinal (IRL) layers. By using the average thickness of the GCL (AUROC = 0.82) and the inter-eye difference in the IPL (AUROC = 0.71) as inputs to a twolayer convolutional neural network, automatic diagnosis attained accuracy = 0.87, sensitivity = 0.82, and specificity = 0.92. Conclusion: This study adds weight to the argument that neuroretinal structure analysis could be incorporated into the diagnostic criteria for MS.

Automated summary

This study aimed to identify new biomarkers for the early diagnosis of multiple sclerosis (MS) using spectral-domain optical coherence tomography (OCT) and artificial intelligence. The analysis of retinal thickness and inter-eye difference revealed that the greatest alteration occurred in the ganglion cell, inner plexiform, and inner retinal layers. By using these parameters for automatic diagnosis, an accuracy of 87%, sensitivity of 82%, and specificity of 92% were achieved, suggesting that neuroretinal structure analysis could be incorporated into the diagnostic criteria for MS.