{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:51:05Z","timestamp":1767703865585,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>There are consolidated data about multiple sclerosis (MS)\u2013dependent retinal neurodegeneration occurring in the optic disk and the macula, although it is unclear whether other retinal regions are affected. Our objective is to evaluate, for the first time, the involvement of the entire retinal posterior pole in patients diagnosed with relapsing remitting multiple sclerosis (RRMS) unaffected by optic neuritis using Spectral Domain\u2013Optical Coherence Tomography (SD\u2013OCT). The study protocol was approved by Tor Vergata Hospital Institutional Ethics Committee (Approval number 107\/16), and conforms to the tenets of the Declaration of Helsinki. After a comprehensive neurological and ophthalmological examination, 53 untreated RRMS patients (aged 37.4 \u00b1 10) and 53 matched controls (aged 36.11 \u00b1 12.94) were enrolled. In addition, each patient underwent an examination of the posterior pole using the SD-OCT built-in Spectralis posterior pole scanning protocol. After segmentation, the mean thickness, as well as the thickness of the 64 single regions of interest, were calculated for each retinal layer. No statistically significant difference in terms of average retinal thickness was found between the groups. However, MS patients showed both a significantly thinner ganglion cell layer (p &lt; 0.001), and, although not statistically significant, a thinner inner nuclear layer (p = 0.072) and retinal nerve fiber layer (p = 0.074). In contrast, the retinal pigment epithelium (p = 0.014) and photoreceptor layers p &lt; 0.001) resulted significantly thicker in these patients. Interestingly, the analysis of the region of interest showed that neurodegeneration was non-homogeneously distributed across each layer. This is the first report that suggests a complex rearrangement that affects, layer by layer, the entire retinal posterior pole of RRMS retinas in response to the underlying neurotoxic insult.<\/jats:p>","DOI":"10.3390\/jcm10204693","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T21:36:15Z","timestamp":1634160975000},"page":"4693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Complex Rearrangement of the Entire Retinal Posterior Pole in Patients with Relapsing Remitting Multiple Sclerosis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3725-8211","authenticated-orcid":false,"given":"Alessio","family":"Martucci","sequence":"first","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3309-8417","authenticated-orcid":false,"given":"Doriana","family":"Landi","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"},{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Cesareo","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1968-0195","authenticated-orcid":false,"given":"Emiliano","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"},{"name":"St\u00e4dtisches Klinikum Karlsruhe, Moltkestra\u00dfe 90, 76133 Karlsruhe, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2359-381X","authenticated-orcid":false,"given":"Giovanni","family":"Di Mauro","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"},{"name":"Neurology Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto Pietro","family":"Sorge","sequence":"additional","affiliation":[{"name":"Laboratory of Biometry, Department of Systems Medicine, University of Rome Tor Vergata, Via Cracovia, 50, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5113-2017","authenticated-orcid":false,"given":"Maria","family":"Albanese","sequence":"additional","affiliation":[{"name":"Neurology Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Gabri Nicoletti","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"},{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Mataluni","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"},{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola Biagio","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"},{"name":"Neurology Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Di Marino","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6479-1807","authenticated-orcid":false,"given":"Francesco","family":"Aiello","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Centonze","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"},{"name":"Unit of Neurology, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via Atinense, 18, 86077 Pozzilli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Nucci","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Girolama Alessandra","family":"Marfia","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Fondazione PTV Policlinico Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy"},{"name":"Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"},{"name":"Unit of Neurology, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via Atinense, 18, 86077 Pozzilli, Italy"},{"name":"Multiple Sclerosis Clinical and Research Unit, Tor Vergata Hospital, Viale Oxford, 81, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Mancino","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/S1474-4422(17)30278-8","article-title":"Retinal layer segmentation in multiple sclerosis: A systematic review and 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