Contributions
Abstract: P1089
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Neuromyelitis optica spectrum disorders (NMOSD) are inflammatory-degenerative diseases of the central nervous system with optic neuritis (ON) as one hallmark. Due to retrograde retinal damage subsequent to ON, peripapillary retinal nerve fibre layer (pRNFL) thinning correlates with visual dysfunction.
Objective: To exclude a potential systematic error by papillary blood vessels in severely thinned RNFL and thus to improve the accuracy of pRNFL thickness measurements in longitudinal clinical trials.
Methods: Forty patients with NMOSD (28 AQP4-positive; 25 with history of ON) were included. All patients underwent pRNFL measurements with spectral domain optic coherence tomography (OCT) and high contrast visual acuity (VA) measurement with Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Blood vessel regions in OCT scans were semi-automatically segmented with OCTSeg.
Results: A total of 77 eyes from 40 NMOSD patients were evaluated. Three eyes were excluded due to insufficient scan quality. A mean pRNFL thickness of 76.1 ± 26.6µm was found in measurements including retinal blood vessels. After exclusion of blood vessel regions, pRNFL measurements were significantly thinner (70.7 ± 26.1µm, p< 0.001). VA was associated with pRNFL including vessels (r=0.621, p< 0.001) and pRNFL without vessels (r=0.619, p< 0.001). The relative blood vessel contribution to RNFL thickness measurements amounted to 8±3% and increased with lower pRNFL (r=-0.698, p< 0.001). When only considering eyes with RNFL thickness below 60µm, the mean relative contribution was 11±3%, and RNFL-VA correlations improved for measurements excluding blood vessels (r=0.523, p=0.004) compared to measurements including blood vessels (r=0.482, p=0.009).
Conclusion: Our findings show a difference between RNFL thickness measurements with and without blood vessels. Relative contribution of blood vessels to RNFL thickness increases with thinner RNFL, which is an important confounder when using RNFL as inter-individual but also as longitudinal intra-individual outcome measure. Excluding blood vessels might improve measurement accuracy in severely affected patients, exemplified by an improved correlation with visual function.
Disclosure: Oertel: This work was supported by the BIH-Charité Medical Student Research Program to Frederike C Oertel.
Zimmermann: received speaking fees from Teva and Bayer.
Mikolacjzak: received speaking fees from Teva and Biogen Idec unrelated to the presented scientific work.
Weinhold: nothing to disclose
Kadas: nothing to disclose
Oberwahrenbrock: is supported by EXIST-Forschungstransfer (German Federal Ministry for Economic Affairs and Energy, 03EFEBE079) and received speaker honorary from TEVA and Bayer unrelated to the presented scientific work.
Pache: This work was supported by the BIH-Charité Clinical Scientist Program to Florence Pache.
Paul: is supported by the Deutsche Forschungsgemeinschaft (DFG EXC257), the Bundesministerium für Bildung und Forschung (BMBF Competence Network Multiple Sclerosis) and the Guthy Jackson Charitable Foundation, he has received travel grants, research support and personal compensation for activities with Alexion, Bayer, MerckSerono, Teva, Sanofi Genzyme, MedImmune, Chugai, BiogenIdec and Novartis and is member of the steering committee of the OCTIMS study (Novartis).
Brandt: is supported by EXIST-Forschungstransfer (German Federal Ministry for Economic Affairs and Energy, 03EFEBE079) and received consulting fees from Biogen, Novartis, Teva, Nexus, and Motognosis and received funding for research from Novartis and Biogen.
Abstract: P1089
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Neuromyelitis optica spectrum disorders (NMOSD) are inflammatory-degenerative diseases of the central nervous system with optic neuritis (ON) as one hallmark. Due to retrograde retinal damage subsequent to ON, peripapillary retinal nerve fibre layer (pRNFL) thinning correlates with visual dysfunction.
Objective: To exclude a potential systematic error by papillary blood vessels in severely thinned RNFL and thus to improve the accuracy of pRNFL thickness measurements in longitudinal clinical trials.
Methods: Forty patients with NMOSD (28 AQP4-positive; 25 with history of ON) were included. All patients underwent pRNFL measurements with spectral domain optic coherence tomography (OCT) and high contrast visual acuity (VA) measurement with Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Blood vessel regions in OCT scans were semi-automatically segmented with OCTSeg.
Results: A total of 77 eyes from 40 NMOSD patients were evaluated. Three eyes were excluded due to insufficient scan quality. A mean pRNFL thickness of 76.1 ± 26.6µm was found in measurements including retinal blood vessels. After exclusion of blood vessel regions, pRNFL measurements were significantly thinner (70.7 ± 26.1µm, p< 0.001). VA was associated with pRNFL including vessels (r=0.621, p< 0.001) and pRNFL without vessels (r=0.619, p< 0.001). The relative blood vessel contribution to RNFL thickness measurements amounted to 8±3% and increased with lower pRNFL (r=-0.698, p< 0.001). When only considering eyes with RNFL thickness below 60µm, the mean relative contribution was 11±3%, and RNFL-VA correlations improved for measurements excluding blood vessels (r=0.523, p=0.004) compared to measurements including blood vessels (r=0.482, p=0.009).
Conclusion: Our findings show a difference between RNFL thickness measurements with and without blood vessels. Relative contribution of blood vessels to RNFL thickness increases with thinner RNFL, which is an important confounder when using RNFL as inter-individual but also as longitudinal intra-individual outcome measure. Excluding blood vessels might improve measurement accuracy in severely affected patients, exemplified by an improved correlation with visual function.
Disclosure: Oertel: This work was supported by the BIH-Charité Medical Student Research Program to Frederike C Oertel.
Zimmermann: received speaking fees from Teva and Bayer.
Mikolacjzak: received speaking fees from Teva and Biogen Idec unrelated to the presented scientific work.
Weinhold: nothing to disclose
Kadas: nothing to disclose
Oberwahrenbrock: is supported by EXIST-Forschungstransfer (German Federal Ministry for Economic Affairs and Energy, 03EFEBE079) and received speaker honorary from TEVA and Bayer unrelated to the presented scientific work.
Pache: This work was supported by the BIH-Charité Clinical Scientist Program to Florence Pache.
Paul: is supported by the Deutsche Forschungsgemeinschaft (DFG EXC257), the Bundesministerium für Bildung und Forschung (BMBF Competence Network Multiple Sclerosis) and the Guthy Jackson Charitable Foundation, he has received travel grants, research support and personal compensation for activities with Alexion, Bayer, MerckSerono, Teva, Sanofi Genzyme, MedImmune, Chugai, BiogenIdec and Novartis and is member of the steering committee of the OCTIMS study (Novartis).
Brandt: is supported by EXIST-Forschungstransfer (German Federal Ministry for Economic Affairs and Energy, 03EFEBE079) and received consulting fees from Biogen, Novartis, Teva, Nexus, and Motognosis and received funding for research from Novartis and Biogen.