Objective. To analyze the interaction between the localization of demyelination plaques and damage to the optic nerve in patients with multiple sclerosis (MS). Material and methods. Fifty-five patients (18 men and 37 women) with a confirmed diagnosis of MS were examined based on magnetic resonance imaging of the brain (MRI) and the conclusion of a neurologist. Four topographic zones of localization of the visual paths were identified: the orbital part of the optic nerve, periventricular white matter, areas of the right and left thalamus, and white matter of the occipital lobe of the big hemispheres. The MRI data were compared with the results of spectral optical coherence tomography (C-OCT) of the same study. Results. The greatest number of demyelination plaques is described in the periventricular white matter of the lateral ventricles, and the smallest number in the white matter of the occipital lobe of the large hemispheres. In patients with optic neuritis (ON), demyelination plaques were also detected in the projection of the orbital part of ON in 18% of cases. A comparison analysis reveals no correlation between the side of optical nerve lesion and the presence of lesions in the projection of the orbital part of ON. The predictive ability of C-OCT of focal changes in the brain in interaction with C-OCT parameters in groups with ON and partial ON atrophy due to MS is not confirmed. Conclusion. In all patients with MS, demyelination plaques are detected in the visual analyzer (VA) projection, even with the manifestation of the disease. In the course of MS progression, their total number increases. Localization of focal demyelination processes in MS in the projection VA and the side of the lesion do not have reliably confirmed the interaction with the parameters of the optic disc in accordance with C-OCT. A lesion of the peripheral neuron VA is identified in all patients.