Contributions
Abstract: P541
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Optic neuritis (ON) as an inflammatory optic neuropathy usually occurs as an early manifestation of multiple sclerosis (MS) and neuromyelitits optica. ON is often an acute, self-limited event that recovers over several weeks. However, visual symptoms persist in 40-60 % of patients. Optic magnetic resonance imaging (MRI) features in the acute phase of the first ON episode remain poorly characterized.
Methods: A prospective cohort study of patients with idiopathic ON in the Region of Southern Denmark from 2014-2016 with a one year follow-up was performed including acute ON evaluation. Patients were seen in a coordinated diagnostic investigation including clinical examination, analysis of blood and cerebrospinal fluid, measurement of evoked potentials, optical coherence tomography and MRI with 1.5 Tesla scanner. MRI was performed within two months of presentation. These studies were evaluated by a neuroradiologist, masked to clinical and serological information.
Results: Sixty-two patients were evaluated for ON and 54 were included in the study. Forty-three patients met the inclusion criteria for acute ON, and 24 had an MRI evaluation at a single episode of ON. Median time between onset of symptoms and MRI was 17.5 days (range 2-55 days). All except one were Caucasian; the female: male ratio was 2:1 and median age at onset was 33 years (range 16-52 years). Twenty-two patients had unilateral and 2 had bilateral ON. Bilateral signal abnormalities on optic nerves on MRI were seen in one patient with only unilateral clinical symptoms. All three with bilateral involvement of optic nerves were females. Signal abnormalities on optic nerve were demonstrated by MRI in 79 % (19/24). Of these 74 % (14/19) had brain MRI abnormalities, 42 % (8/19) of whom met the diagnostic criteria for MS (McDonald dissemination in space criteria) within the acute ON episode. Further studies are in progress.
Conclusions: These preliminary data indicate that signal abnormalities of the optic nerve on MRI occur frequently in the acute phase of a single ON episode. The presence of brain MRI abnormalities at the time of the first acute ON seems to be a relative risk factor for MS.
Disclosure:
K. Soelberg: Nothing to disclose.
HBP. Skejø: Nothing to disclose.
JMJ. Mehlsen: Nothing to disclose.
J. Grauslund: Nothing to disclose.
F. Paul: F. Paul is on the steering committee for Novartis OCTIMS Study and MedImmune; received speaker honoraria and travel grants from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, and Merck Serono; is an academic editor for PLoS ONE; is an associate editor for Neurology®: Neuroimmunology & Neuroinflammation; has consulted for SanofiGenzyme, Biogen Idec, and MedImmune; and received research support from Bayer, Novartis,Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Merck Serono, GermanResearch Council, Werth Stiftung of the City of Cologne, German Ministry of Education and Research, Arthur Arnstein Foundation Berlin, Guthy Jackson Charitable Foundation, and National Multiple SclerosisSociety of the USA.
TJ. Smith: Received research support from River Vision, NIH, University of South Denmark, Bell Charitable Foundation, Research to Prevent Blindness Foundation; he is an advisor to the Guthy-Jackson Charitable Foundation. He is scientific and medical director of the Graves" disease and Thyroid Foundation, has been a paid consultant for Lipothera, River Vision, Wyeth, Merck, and Novartis, and holds patents for anti-IGF-1 receptor monoclonal therapy in autoimmune diseases.
ST. Lillevang: Nothing to disclose.
BG. Weinshenker: Royalties related to patent for discovery of NMO-IgG; licensed to RSR, Ltd., Oxford University, Member DSMB; Biogen Idec (Chair), Novartis and Mitsubishi (Chair). Attack Adjudication Committee; MedImmune Pharmaceuticals. Miscellaneous consulting; Chugai Pharmaceuticals and Chord Pharmaceuticals
N. Asgari: Nothing to disclose.
Study funding: The Danish Multiple Sclerosis Society. The Region of Southern Denmark Research.
The University of Southern Denmark. Engineer Bent Bøgh, wife Inge Bøghs Foundation. Manufacturer Einar Willumsens Memorial Grant. Foundation of Lægevidenskabens Fremme. Torben and Alice Frimodts Foundation. The Hospital of Lillebaelt Foundation.
Abstract: P541
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Optic neuritis (ON) as an inflammatory optic neuropathy usually occurs as an early manifestation of multiple sclerosis (MS) and neuromyelitits optica. ON is often an acute, self-limited event that recovers over several weeks. However, visual symptoms persist in 40-60 % of patients. Optic magnetic resonance imaging (MRI) features in the acute phase of the first ON episode remain poorly characterized.
Methods: A prospective cohort study of patients with idiopathic ON in the Region of Southern Denmark from 2014-2016 with a one year follow-up was performed including acute ON evaluation. Patients were seen in a coordinated diagnostic investigation including clinical examination, analysis of blood and cerebrospinal fluid, measurement of evoked potentials, optical coherence tomography and MRI with 1.5 Tesla scanner. MRI was performed within two months of presentation. These studies were evaluated by a neuroradiologist, masked to clinical and serological information.
Results: Sixty-two patients were evaluated for ON and 54 were included in the study. Forty-three patients met the inclusion criteria for acute ON, and 24 had an MRI evaluation at a single episode of ON. Median time between onset of symptoms and MRI was 17.5 days (range 2-55 days). All except one were Caucasian; the female: male ratio was 2:1 and median age at onset was 33 years (range 16-52 years). Twenty-two patients had unilateral and 2 had bilateral ON. Bilateral signal abnormalities on optic nerves on MRI were seen in one patient with only unilateral clinical symptoms. All three with bilateral involvement of optic nerves were females. Signal abnormalities on optic nerve were demonstrated by MRI in 79 % (19/24). Of these 74 % (14/19) had brain MRI abnormalities, 42 % (8/19) of whom met the diagnostic criteria for MS (McDonald dissemination in space criteria) within the acute ON episode. Further studies are in progress.
Conclusions: These preliminary data indicate that signal abnormalities of the optic nerve on MRI occur frequently in the acute phase of a single ON episode. The presence of brain MRI abnormalities at the time of the first acute ON seems to be a relative risk factor for MS.
Disclosure:
K. Soelberg: Nothing to disclose.
HBP. Skejø: Nothing to disclose.
JMJ. Mehlsen: Nothing to disclose.
J. Grauslund: Nothing to disclose.
F. Paul: F. Paul is on the steering committee for Novartis OCTIMS Study and MedImmune; received speaker honoraria and travel grants from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, and Merck Serono; is an academic editor for PLoS ONE; is an associate editor for Neurology®: Neuroimmunology & Neuroinflammation; has consulted for SanofiGenzyme, Biogen Idec, and MedImmune; and received research support from Bayer, Novartis,Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Merck Serono, GermanResearch Council, Werth Stiftung of the City of Cologne, German Ministry of Education and Research, Arthur Arnstein Foundation Berlin, Guthy Jackson Charitable Foundation, and National Multiple SclerosisSociety of the USA.
TJ. Smith: Received research support from River Vision, NIH, University of South Denmark, Bell Charitable Foundation, Research to Prevent Blindness Foundation; he is an advisor to the Guthy-Jackson Charitable Foundation. He is scientific and medical director of the Graves" disease and Thyroid Foundation, has been a paid consultant for Lipothera, River Vision, Wyeth, Merck, and Novartis, and holds patents for anti-IGF-1 receptor monoclonal therapy in autoimmune diseases.
ST. Lillevang: Nothing to disclose.
BG. Weinshenker: Royalties related to patent for discovery of NMO-IgG; licensed to RSR, Ltd., Oxford University, Member DSMB; Biogen Idec (Chair), Novartis and Mitsubishi (Chair). Attack Adjudication Committee; MedImmune Pharmaceuticals. Miscellaneous consulting; Chugai Pharmaceuticals and Chord Pharmaceuticals
N. Asgari: Nothing to disclose.
Study funding: The Danish Multiple Sclerosis Society. The Region of Southern Denmark Research.
The University of Southern Denmark. Engineer Bent Bøgh, wife Inge Bøghs Foundation. Manufacturer Einar Willumsens Memorial Grant. Foundation of Lægevidenskabens Fremme. Torben and Alice Frimodts Foundation. The Hospital of Lillebaelt Foundation.