Spectral domain‐optical coherence tomography plays a crucial role in the early detection and monitoring of multiple sclerosis (MS) pathophysiology. We aimed to quantify differences in retinal layer measures among different groups of MS and explored different variables that correlate with retinal measures. This study was reported according PRISMA guidelines. A comprehensive search was done across PubMed, Embase, and Google Scholar. The mean difference in thickness of retinal layers and macular volume was assessed. Meta‐regression was done to assess the sources of heterogeneity. A total of 100 articles were included in the meta‐analyses. The peripapillary retinal nerve fiber layer (pRNFL) thickness significantly decreased in the MSON (MD: −16.44, P < 0.001), MSNON (MD: −6.97, P < 0.001), and PMS (MD: −11.35, P < 0.001) versus HC. The macular RNFL was lower among the MSON (MD: −6.24, P = 0.013) and MSNON (MD: −3.84, P <0.001) versus HC. Macular ganglion cell layer and inner plexiform layer (GCIPL) was thinner among MSON (MD: −14.83, P <0.001), MSNON (MD: −6.38, P < 0.001), and PMS (MD: −11.52, P < 0.001) compared with control eyes. Inner nuclear layer (INL) was higher in the MSON (MD: 0.49, P < 0.001) versus HC. Outer nuclear layer (ONL) thickness significantly lower in the MSNON (MD: −1.15, P = 0.019) versus HC. Meta‐regression showed that disease duration, age, EDSS score, and percentage of patients taking DMT are all negatively correlated with pRNFL and GCIPL thickness; however, female gender was correlated with less atrophy. As conclusion, the study highlights substantial thinning in the pRNFL and macular GCIPL between MS versus controls. INL as valuable parameter for capturing inflammatory disease activity.

Background: Behçet’s Disease (BD) is a complex vasculitis affecting multiple organ systems, with Neuro-Behçet’s Disease (NBD) representing a rare yet severe manifestation. Data on NBD are limited, particularly in Middle Eastern populations. Methods: This retrospective observational study, spanning from 2000 to 2021, involved 262 BD patients at a tertiary medical center in Lebanon. NBD was diagnosed based on International Consensus Recommendation diagnostic criteria. Clinical data, including demographics, manifestations, inflammatory blood markers, genetics, and treatments, were collected. The modified Rankin Scale (mRS) was used to assess disease severity. Results: Among the cohort, 27 (10.3%) had NBD, with headaches, weakness, and dizziness as the most common presenting symptoms. The prevalence of NBD was similar across genders, which differs from some regional studies. HLA-B51 positivity was found in 50 out of 60 (83.3%) tested BD patients. Parenchymal NBD cases exhibited greater disease severity than non-parenchymal cases, with female patients experiencing a more severe course compared to males. Elevated inflammatory markers (CRP and ESR) were more common in patients with severe NBD. Corticosteroids and colchicine were the most commonly used therapies overall, while patients with better disease severity were more frequently prescribed methotrexate, mycophenolate, cyclophosphamide, adalimumab, and rituximab. An analysis of disease progression showed that at presentation, 57.1% (n = 12) of NBD patients had mild to moderate disability, which increased to 76.2% (n = 16) at the last follow-up, including 10 patients who showed an improvement in their mRS score. Conclusions: This study provides valuable insights into the prevalence and clinical characteristics of NBD in a Middle Eastern population. These findings enhance our understanding of NBD in the Middle East, highlighting the need for further research to improve diagnosis and management.

Objective: We aimed to investigate the comparative effectiveness of standard versus personalized extended interval dosing of anti‐CD20 therapy on clinical and sub‐clinical outcomes in multiple sclerosis.Methods: Clinical information was collected prospectively on Research Electronic Data Capture. Patients with age ≥ 18 years old, confirmed diagnosis of multiple sclerosis, treatment with B‐cell depleting drug (Rituximab and Ocrelizumab), and minimum follow‐up of 12 months with at least 3 clinical visits and at least 3 infusions of medication were included and divided into an extended interval dosing group, a standard interval dosing group, and a converters group who switched from standard to extended interval dosing. Retinal measures were obtained using spectral domain Optical Coherence Tomography. Magnetic resonance imaging acquisitions were performed in two centers using a standardized conventional imaging protocol for multiple sclerosis.Results: Patients had a median clinical follow‐up of 3.5 (0.44–7.3) years, retinal OCT follow‐up of 2.6 (1.4) years, and MRI follow‐up of 2.6 (1.1) years. Annualized changes in clinical measures, retinal measures, and brain volumetric measures were similar between the 3 groups. Multivariate regression analyses also showed no differences.Interpretation: We found no differences in clinical or sub‐clinical outcomes between patients treated with standard interval dosing, patients converting from standard to extended interval dosing, and patients on extended interval dosing of B‐cell depleting drugs.

Objective: This study assessed whether upper cervical cord area (UCCA) measured on routine brain MRI can serve as a biomarker of conversion to SPMS. Methods: This is a single‐center retrospective cohort study of RRMS patients with cross‐sectional and longitudinal analyses of clinical and MRI data. Future SPMS converters were matched by age, sex, and disease duration with non‐converters. UCCA at C1–C3 was measured at a pre‐conversion visit in converters and at the first available visit in non‐converters. Analysis was performed using Pearson's correlation and multivariable logistic regression. Longitudinal analyses included patients with ≥ 6 months MRI interval (mean follow‐up 3.38 ± 1.88 years). Results: 97 patients (32 converters, 65 non‐converters) were included. Cross‐sectionally, reduced C2 and C3 area was associated with conversion (C2: OR 1.09, p = 0.01; C3: OR 1.09, p = 0.014). Lower UCCA correlated with higher EDSS (C2: r = −0.496, p < 0.001), worse T25‐FWT (C2: r = −0.388, p < 0.001) and 9‐HPT (C2: r = −0.312, p = 0.003), and reduced white matter and thalamic volumes ( p ≤ 0.006). Longitudinal analysis ( n = 50; 16 converters, 34 non‐converters) demonstrated atrophy in converters at C1, C2 and C3 (C1: OR 1.70, p = 0.014; C2: OR 1.74, p = 0.003; C3: OR 1.75, p = 0.002), with mean annual percent reductions of 5.0%, 5.2%, and 6.0%, respectively. Interpretation: Reduced UCCA and accelerated upper cervical cord atrophy were associated with conversion to SPMS and worsening disability, supporting UCCA as an accessible imaging biomarker of MS progression.

To assess whether lesion-related white matter tract disconnection is associated with clinical impairment in relapsing-remitting multiple sclerosis (RRMS) a