Diagnostic accuracy of inter-eye difference of ganglion cell layer alone in identifying optic neuritis in multiple sclerosis

This is the authors' abstract. We don't add key points for this paper.

INTRODUCTION: The 2024 McDonald criteria for diagnosing multiple sclerosis (MS) include optic nerve involvement as a fifth region for establishing dissemination in space. Optic neuritis (ON) can be detected through optical coherence tomography (OCT) using an inter-eye absolute or percentage difference (IEAD, IEPD) in ganglion cell-inner plexiform layer (GCIPL) thickness. OBJECTIVE: To compare the diagnostic accuracy of GCIPL IEAD/IEPD with GCL and IPL IEAD/IEPD alone for identifying a history of ON. METHODS: This cross-sectional retrospective study included people with MS (pwMS) who underwent an OCT scan. Diagnostic accuracy was assessed using ROC analysis. RESULTS: or ⩾2µm, 58.9% sensitivity, 85.1% specificity) and IEPD (AUC 0.80, cut-off ⩾ 3%, 48.7% sensitivity, 89.8% specificity) demonstrated excellent diagnostic accuracy for unilateral ON, showing non-inferiority to the established GCIPL IEAD/IEPD. CONCLUSION: GCL IEAD and IEPD provide strong diagnostic accuracy for identifying unilateral ON and can be effectively used as an alternative to GCIPL IEAD/IEPD to facilitate implementation in clinical routine.