Use of optical coherence tomography in the care of people with multiple sclerosis in Switzerland: A national survey among neurologists

Background: Optical coherence tomography (OCT) can assess optic nerve involvement and facilitate the diagnosis of multiple sclerosis (MS). Objective: To evaluate the current use of OCT for MS care among neurologists in Switzerland. Methods: Nationwide online survey with Swiss neurologists, comprising 11 questions on availability, use of OCT, and its role in diagnostic workup and monitoring. Results: Thirty-four neurologists from all main Swiss regions responded (53% hospital-based, 47% private practice). Only 26.5% had access to OCT in their clinic/practice, all of whom were MS specialists, mainly hospital-based (66.7%). All respondents assess the visual pathway in first demyelinating event and optic neuritis (ON), primarily using magnetic resonance imaging (MRI: 88.2% and 91.2%, respectively), often in combination with visual evoked potentials (VEP). OCT use was reported by 32% (first demyelinating event) and 44% (ON) of respondents. OCT was infrequently used for monitoring (20.6%), the most frequent reasons being “lack of availability” or “insufficient evidence.” Conclusions: Despite the scientific evidence, OCT availability and routine use by neurologists is limited in Switzerland. Awareness, education and guidelines on its clinical use in MS care are needed, while ongoing real-world research should shed more light into its role for personalized disease monitoring in people with MS.