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In this review, we analyze OCT-A studies in patients with MS and examine its utility as a surrogate or precursor to changes in central nervous system tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and EMBASE were systematically searched to identify articles that applied OCT-A to evaluate the retinal microvasculature measurements in patients with MS. Quantitative data synthesis was performed on all measurements which were evaluated in at least two unique studies with the same OCT-A devices, software, and study population compared to controls. A fixed-effects or random-effects model was applied for the meta-analysis based on the heterogeneity level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study selection process yielded the inclusion of 18 studies with a total of 1552 evaluated eyes in 673 MS-associated optic neuritis (MSON) eyes, 741 MS without optic neuritis (MSNON eyes), and 138 eyes without specification for the presence of optic neuritis (ON) in addition to 1107 healthy control (HC) eyes. Results indicated that MS cases had significantly decreased whole image superficial capillary plexus (SCP) vessel density when compared to healthy control subjects in the analyses conducted on Optovue and Topcon studies (both\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Likewise, the whole image vessel densities of deep capillary plexus (DCP) and radial peripapillary capillary (RPC) were significantly lower in MS cases compared to HC (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Regarding optic disc area quadrants, MSON eyes had significantly decreased mean RPC vessel density compared to MSNON eyes in all quadrants except for the inferior (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Results of the analysis of studies that used prototype Axsun machine revealed that MSON and MSNON eyes both had significantly lower ONH flow index compared to HC (both\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis of the studies reporting OCT-A measurements of people with MS confirmed the tendency of MS eyes to exhibit reduced vessel density in the macular and optic disc areas, mainly in SCP, DCP, and RPC vessel densities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12974-023-02763-4","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T20:19:18Z","timestamp":1680725958000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"20","author":[{"given":"Soheil","family":"Mohammadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Gouravani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Amin","family":"Salehi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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He has performed consulting for Novartis, Genentech Corporation, JuneBrain LLC, and Lapix therapeutics. He is the PI of investigator-initiated studies funded by Genentech Corporation, Novartis, and Biogen. He previously received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC and Lapix therapeutics. He was also the site investigator of trials sponsored by MedDay Pharmaceuticals, Clene Pharmaceuticals, and is the site investigator of a trial sponsored by Novartis. Dr. Sattarnezhad has received Sylvia Lawry Physician Fellowship award from National Multiple Sclerosis Society (NMSS). Elliot Frohman has received consulting and speaker fees from Biogen, Genzyme, Novartis, Alexion, Horizon, and Janssen. Soheil Mohammadi, Mahdi Gouravani, Mohammad Amin Salehi, J. Fernando Arevalo, Steven L. Galetta, Hamid Harandi, Teresa C Frohman, and Friedemann Paul report no disclosures.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"85"}}