Mitochondrial failure and hypoxia are key contributors to multiple sclerosis pathophysiology. Importantly, improving mitochondrial function holds promise as a new therapeutic strategy in multiple sclerosis. Currently, studying mitochondrial changes in multiple sclerosis is hampered by a paucity of non-invasive techniques to investigate mitochondrial function of the CNS in vivo. It is against this backdrop that the anterior visual system provides new avenues for monitoring of mitochondrial changes. The retina and optic nerve are among the metabolically most active structures in the human body and are almost always affected to some degree in multiple sclerosis. Here, we provide an update on emerging technologies that have the potential to indirectly monitor changes of metabolism and mitochondrial function. We report on the promising work with optical coherence tomography, showing structural changes in outer retinal mitochondrial signal bands, and with optical coherence angiography, quantifying retinal perfusion at the microcapillary level. We show that adaptive optics scanning laser ophthalmoscopy can visualize live perfusion through microcapillaries and structural changes at the level of single photoreceptors and neurons. Advantages and limitations of these techniques are summarized with regard to future research into the pathology of the disease and as trial outcome measures.

中文翻译：

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前视觉系统成像以研究多发性硬化症中的能量衰竭。

线粒体衰竭和缺氧是多发性硬化症病理生理学的关键因素。重要的是，改善线粒体功能有望成为多发性硬化症的新治疗策略。目前，缺乏多方面的非侵入性技术来研究中枢神经系统在体内的线粒体功能阻碍了研究多发性硬化中线粒体的变化。在这种背景下，前视觉系统为监测线粒体的变化提供了新的途径。视网膜和视神经是人体代谢最活跃的结构之一，在多发性硬化症中几乎总是受到一定程度的影响。在这里，我们提供了新兴技术的更新，这些技术有可能间接监测新陈代谢和线粒体功能的变化。我们报道了光学相干断层扫描的有希望的工作，显示了外部视网膜线粒体信号带的结构变化，以及光学相干血管造影，定量了微毛细管水平的视网膜灌注。我们显示自适应光学扫描激光检眼镜可以通过单个毛细血管和神经元水平的微毛细血管和结构变化可视化实时灌注。总结了这些技术的优点和局限性，以作为对疾病病理学的未来研究和试验结果的衡量标准。