The most socioeconomically disadvantaged groups of individuals may be at increased risk of faster retinal neurodegeneration from multiple sclerosis. Raising awareness on this inequality may help promote the implementation of efficient treatment solutions in patients with low socioeconomic status.
Multiple sclerosis is an autoimmune disease characterized by demyelination, inflammation, and neurodegeneration. However, symptoms and outcomes of the disease can vary widely among individuals. Few studies have examined the full impact of socioeconomic status (SES) on the progression of disease, although some studies have suggested that low SES is linked to a more proinflammatory phenotype.
The objective of a study published in Brain was to evaluate whether SES is linked to the rate of retinal neurodegeneration. Researchers used a range of indicators to assess socioeconomic status on both neighborhood and individual levels. Neighborhood-level indicators included national and state deprivation indices, the Agency for Healthcare Research and Quality (AHRQ) Socioeconomic Status Index, and median household income, while individual-level indicators included education level. Biannual optical coherence tomography scans were implemented to assess the thickness of the composite macular ganglion cell+inner plexiform (GCIPL) layer and overall rates of retinal neurodegeneration.
The rates of GCIPL atrophy for individuals in socioeconomically disadvantaged groups were faster across all SES indicators. For example, according to state area deprivation indices, the difference in GCIPL atrophy for the most disadvantaged groups of people was โ0.12 ยตm/year faster than for the least disadvantaged groups of people. A lower SES was also associated with a higher risk of comorbidity, low-contrast letter acuity loss, and increased rates of therapy escalation.
Clinicians are encouraged to mitigate retinal neurodegeneration and assess the impact of inequalities on a socioeconomic level. Efficient and rapid treatment management could mean the difference between preventing worsened comorbidity and improved disease outcomes.
Source:
Vasileiou, E. S., Filippatou, A. G., Pimentel Maldonado, D., Kalaitzidis, G., Ehrhardt, H., Lambe, J., Saidha, S., Sotirchos, E. S., Mowry, E. M., Calabresi, P. A., & Fitzgerald, K. C. (2021). Socioeconomic disparity is associated with faster retinal neurodegeneration in multiple sclerosis. Brain, 144(12), 3664-3673. https://doi.org/10.1093/brain/awab342