166: Understanding RNFL Asymmetry as a Biomarker in Pediatric MS

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.In this Mind Moments episode, Scott Grossman, MD, assistant professor of neurology and ophthalmology at NYU Grossman School of Medicine, discusses emerging research on inter-eye retinal nerve fiber layer (RNFL) asymmetry as a biomarker of prior optic neuritis in pediatric-onset multiple sclerosis (POMS). Drawing from data presented at the 2026 American Academy of Neurology Annual Meeting, Grossman explains how optical coherence tomography (OCT) may help improve diagnostic confidence in pediatric MS by identifying remote optic nerve injury, while also outlining how a 4-micron inter-eye RNFL difference emerged as the optimal threshold in this cohort. The conversation also explores the role of OCT within the updated 2024 McDonald Criteria, the feasibility of integrating OCT into routine neurology practice, challenges surrounding normative pediatric OCT data, and future research directions involving visible light OCT and broader population datasets. Looking for more Multiple Sclerosis discussion? Check out the NeurologyLive® Multiple Sclerosis clinical focus page.Episode Breakdown: 1:15 – Optic nerve involvement and updated MS diagnostic criteria  3:20 – Pediatric RNFL asymmetry thresholds and interpretation of study findings 5:15 – Clinical implications of OCT biomarkers in pediatric-onset MS  6:40 – Neurology News Network  8:40 – Feasibility of incorporating OCT into neurology and MS practice  10:15 – Future research directions, including normative data and visible light OCT The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: FDA Approves AXS-05 as New Treatment for Alzheimer Disease Agitation FDA Approves Ocrelizumab for Pediatric Patients With Relapsing-Remitting Multiple Sclerosis Efgartigimod Gains FDA Approval as First Treatment for Seronegative Forms of Myasthenia Gravis Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.