Abstract: P561
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neurophysiology
Background: Our previous publication1 indicates that Multifocal Objective Pupil Perimetry (mfPOP) may provide disease severity measures in Multiple Sclerosis (MS) patients. A new measure based on the asymmetry between mfPOP results for the two eyes appears to improve on the earlier result.
Methods: 35 normal controls and 85 MS subjects (72 relapsing remitting MS (RR), 13 Progressive or Secondary MS patients (PoS)) were enrolled. MfPOP responses were obtained using the FDA cleared nuCoria® Field Analyser that concurrently tested 44 visual field regions in each of the two eyes. Each region was analysed for deviations from normal according to response time to peak. Patients were grouped into 3 cohorts: EDSS < 3 (N=25), EDSS > 3 and < =4 (N=30), and EDSS > 4 (N=30). (ON): 66 subjects had optic neuritis (ON) vs. 104 with no ON. Diagnostic power was assessed by percentage area under ROC curves (%AUC) based on per region response delays relative to normal.
Results: By our published method where eyes were individually classified the %AUCs for the three EDSS groups were: 62.5, 74.7, and 77.2 (all < ± 5.1%): while asymmetry gave 78.3, 82.9, and 85.8% (all < ± 4.6%). For ON vs. no ON subjects the published per eye method gave %AUCs of 75.4 ± 3.84 and 75.7 ± 4.4 (mean ± SE), while asymmetry gave 81.3 ± 3.24 and 81.8 ± 3.83. For RR and PS patients with EDSS ≥ 5 (means 5.29 and 5.90) the %AUCs were 91.5 and 94.8 respectively. Scores for each control and patient based the first principle component of: the mean delay, the mean of the worst 7/44 region delays, and the mean of the worst 7/44 asymmetries were entered into a bootstrap cross-validated ROC analysis (1000 repeats) yielded %AUCs for the three EDSSS categories of 98.6 ± 1.23, 99.9 ± 0.11 and 99.9 ± 0.05%.
Conclusions: The mfPOP results seemed to depend more on disease progression than the history of acute optic neuritis. Asymmetry between delays at anatomically equivalent visual field regions across eyes gave improved %AUC values compared to delays within each eye.
EN Ali et al. MS Journal 2014: 20(7), 854-861.
Disclosure:
EN Ali, C.J Lueck, AC Jame: nothing to disclose
C Carle: nuCoria Pty Ltd: equity, patent application made for mfPOP
T Maddess: Carl Zeiss; Meditec: patents, royalties. EyeCo Ltd: consultant, equity. nuCoria Pty Ltd: consultants, equity, patents under license, patent application made for mfPOP
Abstract: P561
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neurophysiology
Background: Our previous publication1 indicates that Multifocal Objective Pupil Perimetry (mfPOP) may provide disease severity measures in Multiple Sclerosis (MS) patients. A new measure based on the asymmetry between mfPOP results for the two eyes appears to improve on the earlier result.
Methods: 35 normal controls and 85 MS subjects (72 relapsing remitting MS (RR), 13 Progressive or Secondary MS patients (PoS)) were enrolled. MfPOP responses were obtained using the FDA cleared nuCoria® Field Analyser that concurrently tested 44 visual field regions in each of the two eyes. Each region was analysed for deviations from normal according to response time to peak. Patients were grouped into 3 cohorts: EDSS < 3 (N=25), EDSS > 3 and < =4 (N=30), and EDSS > 4 (N=30). (ON): 66 subjects had optic neuritis (ON) vs. 104 with no ON. Diagnostic power was assessed by percentage area under ROC curves (%AUC) based on per region response delays relative to normal.
Results: By our published method where eyes were individually classified the %AUCs for the three EDSS groups were: 62.5, 74.7, and 77.2 (all < ± 5.1%): while asymmetry gave 78.3, 82.9, and 85.8% (all < ± 4.6%). For ON vs. no ON subjects the published per eye method gave %AUCs of 75.4 ± 3.84 and 75.7 ± 4.4 (mean ± SE), while asymmetry gave 81.3 ± 3.24 and 81.8 ± 3.83. For RR and PS patients with EDSS ≥ 5 (means 5.29 and 5.90) the %AUCs were 91.5 and 94.8 respectively. Scores for each control and patient based the first principle component of: the mean delay, the mean of the worst 7/44 region delays, and the mean of the worst 7/44 asymmetries were entered into a bootstrap cross-validated ROC analysis (1000 repeats) yielded %AUCs for the three EDSSS categories of 98.6 ± 1.23, 99.9 ± 0.11 and 99.9 ± 0.05%.
Conclusions: The mfPOP results seemed to depend more on disease progression than the history of acute optic neuritis. Asymmetry between delays at anatomically equivalent visual field regions across eyes gave improved %AUC values compared to delays within each eye.
EN Ali et al. MS Journal 2014: 20(7), 854-861.
Disclosure:
EN Ali, C.J Lueck, AC Jame: nothing to disclose
C Carle: nuCoria Pty Ltd: equity, patent application made for mfPOP
T Maddess: Carl Zeiss; Meditec: patents, royalties. EyeCo Ltd: consultant, equity. nuCoria Pty Ltd: consultants, equity, patents under license, patent application made for mfPOP