Longitudinal Retinal and Cervical Spinal Cord Changes in Multiple Sclerosis: Associations with Clinical, Cognitive, and Motor Measures

Background/Objectives: Multiple sclerosis (MS) is a central nervous system disease that can cause severe disability. Identifying biomarkers associated with disease progression and disability is important for MS follow-up. Optical coherence tomography (OCT) parameters, measurements of cervical spinal atrophy, and cognitive and motor performance tests were evaluated along with their changes over one year to investigate their potential role in MS follow-up. Methods: This retrospective study included 79 patients with MS. OCT and cervical magnetic resonance imaging performed at 1-year intervals, along with cognitive and motor performance tests, were evaluated. Cervical mean cross-sectional area (mCSA) was used to assess spinal atrophy. Results: Over one year, cervical mCSA and ganglion cell–inner plexiform layer (GCIPL) measurements significantly decreased. Their annual changes were not significantly correlated in the Pearson analysis. The age-, sex-, and disease-duration-adjusted linear analysis likewise did not identify a statistically significant association. Conclusions: Cervical mCSA and GCIPL thickness significantly decreased over one year, but their changes were not significantly correlated. These findings suggest that cervical mCSA and GCIPL may provide complementary information on longitudinal structural changes in MS. However, because measurement reproducibility and absolute error were not quantified for the single-reader cervical measurements, the observed mCSA decrease should be interpreted cautiously, as the extent to which it reflects biological change rather than measurement variability remains uncertain. The clinical relevance of these findings requires further validation.