New challenges in addressing retinal neurodegeneration have emerged as socioeconomic status may play a more critical role than previously thought. Racial disparities in comorbidities associated with multiple sclerosis (MS) may need to be evaluated more closely.
Multiple sclerosis (MS) is an inflammatory demyelinating disease that, without proper treatment can progressively affect the central nervous system and cause complications. What exactly drives disability in patients with MS? Previous studies have indicated that faster rates of retinal neurodegeneration and even retinal neuronal loss are higher in patients of African descent. However, the catalyst for worse outcomes may be attributed to low socioeconomic status rather than ethnicity or race.
In a relatively recent issue of Brain, researchers used optical coherence tomography (OCT) to analyze neuro-axonal atrophy as it relates to socioeconomic factors. They then developed a model to identify causes of faster rates of retinal neurodegeneration in certain groups of people with low socioeconomic advantage. Specifically, researchers identified neuro-axonal atrophy as a factor of macular ganglion cell+inner plexiform (GCIPL) loss.
The authors of the analysis suggest that socioeconomic status be added to the existing models that evaluate risk factors for disability with multiple sclerosis. Evidence from this analysis also highlights the potential for SES to act as a secondary factor that may modify or amplify other factors associated with worsened comorbidity. Factors associated with worsened MS comorbidity include baseline weight, weight gain, smoking status, and probability of therapy escalation, according to the authors.
In order to address inequalities in retinal neurodegeneration between groups of people with varying levels of socioeconomic status, clinicians are encouraged to implement more targeted and personalized approaches to care. Addressing these inequalities may help lower overall healthcare costs and improve patient outcomes linked to potential disabilities with MS.
Source:
Green, A. J. (2021). Socioeconomic disadvantage in multiple sclerosis: does inequality act on the substrate for disability? Brain, 144(12), 3552-3554. https://doi.org/10.1093/brain/awab424
