Contributions
Abstract: 100
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Optical coherence tomography (OCT) derived measures of retinal layer thicknesses have been shown to correlate with visual function, grey matter volume and Expanded Disability Status Scale (EDSS) scores in multiple sclerosis (MS). However, the prognostic value of retinal measurements for predicting long term disability in MS patients is still being evaluated.
Goal: To determine whether retinal thicknesses as assessed by OCT predict disability in MS 10 years later.
Methods: A total of 89 MS patients who were scanned on Stratus OCT between 2006 and 2007 underwent formal, blinded EDSS determination during 2015-2016. Average peripapillary retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) were assessed by calculating the mean value of these measures for both eyes in each subject. Patients were categorised by baseline diagnosis as relapsing remitting (RRMS), secondary progressive (SPMS), or primary progressive MS (PPMS). Mixed effects linear regression models were used to investigate whether average TMV and RNFL thicknesses at baseline predict EDSS scores after 10 years.
Results: The final analysis included 75 RRMS, 9 SPMS, and 5 PPMS patients. 14 of the 75 patients with a baseline diagnosis of RRMS transitioned to SPMS during follow-up period. Baseline analyses revealed that the RRMS cohort was significantly younger than the SPMS and PPMS cohorts (mean differences= 21.5 years and 11.7 years respectively; p< 0.001 for both) and that SPMS patients had a longer disease duration than RRMS and PPMS patients (mean differences=14.2 years and 13.2 years respectively; p< 0.001 for both). A history of optic neuritis (ON) was observed in the RRMS and SPMS cohorts (41% and 44%, respectively), but not in the PPMS cohorts (0%; p=0.253). Adjusting for age, sex, and a history of ON, the mean TMV values at baseline predicted EDSS scores after a median follow-up of 9.3 years. On average, a 1mm3 lower TMV value at baseline predicts a mean decrease of 2 in EDSS at follow-up (adjusted R2=0.20; p=0.012). Mean baseline RNFL values did not significantly predict EDSS scores (adjusted R2=0.18; p=0.069).
Conclusions: As has been previously shown with brain atrophy and lesion volume, retinal measures can have predictive value for medium-term disability in MS. Our preliminary findings support the utility of OCT as a tool to predict neurodegeneration and disease progression over time in MS patients.
Disclosure: Julia Button has no disclosures.
Alissa Rothman has no disclosures.
Laura Balcer has received consulting fees from Biogen and Genzyme and has received research funding from Biogen.
Elliot Frohman has received speaker and consulting fees from Novartis, Genzyme, Acorda and TEVA.
Teresa Frohman has received speaker and consultant fees from Novartis, Genzyme, and Acorda.
Daniel Reich research funding from Intramural Research Program of NINDS, Myelin Repair Foundation, and Vertex Pharmaceuticals (none relevant to this abstract).
Shiv Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology, consulting fees from Axon Advisors LLC, Educational Grant Support from Novartis & Teva Neurosciences, speaking honoraria from the National Association of Managed Care Physicians, Advanced Studies in Medicine and the Family Medicine Foundation of West Virginia, and served on scientific advisory boards for Biogen-Idec, Genzyme & Novartis. He is a researcher in the OCTIMS study. He receives research funding from the Race to Erase MS and Genentech Corporation.
Peter A Calabresi has received consulting fees from Vertex, Abbvie, and Merck and has received research funding from Biogen, Novartis and MedImmune. He is co-chairman of the scientific advisory board of the OCTIMS study.
Abstract: 100
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Optical coherence tomography (OCT) derived measures of retinal layer thicknesses have been shown to correlate with visual function, grey matter volume and Expanded Disability Status Scale (EDSS) scores in multiple sclerosis (MS). However, the prognostic value of retinal measurements for predicting long term disability in MS patients is still being evaluated.
Goal: To determine whether retinal thicknesses as assessed by OCT predict disability in MS 10 years later.
Methods: A total of 89 MS patients who were scanned on Stratus OCT between 2006 and 2007 underwent formal, blinded EDSS determination during 2015-2016. Average peripapillary retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) were assessed by calculating the mean value of these measures for both eyes in each subject. Patients were categorised by baseline diagnosis as relapsing remitting (RRMS), secondary progressive (SPMS), or primary progressive MS (PPMS). Mixed effects linear regression models were used to investigate whether average TMV and RNFL thicknesses at baseline predict EDSS scores after 10 years.
Results: The final analysis included 75 RRMS, 9 SPMS, and 5 PPMS patients. 14 of the 75 patients with a baseline diagnosis of RRMS transitioned to SPMS during follow-up period. Baseline analyses revealed that the RRMS cohort was significantly younger than the SPMS and PPMS cohorts (mean differences= 21.5 years and 11.7 years respectively; p< 0.001 for both) and that SPMS patients had a longer disease duration than RRMS and PPMS patients (mean differences=14.2 years and 13.2 years respectively; p< 0.001 for both). A history of optic neuritis (ON) was observed in the RRMS and SPMS cohorts (41% and 44%, respectively), but not in the PPMS cohorts (0%; p=0.253). Adjusting for age, sex, and a history of ON, the mean TMV values at baseline predicted EDSS scores after a median follow-up of 9.3 years. On average, a 1mm3 lower TMV value at baseline predicts a mean decrease of 2 in EDSS at follow-up (adjusted R2=0.20; p=0.012). Mean baseline RNFL values did not significantly predict EDSS scores (adjusted R2=0.18; p=0.069).
Conclusions: As has been previously shown with brain atrophy and lesion volume, retinal measures can have predictive value for medium-term disability in MS. Our preliminary findings support the utility of OCT as a tool to predict neurodegeneration and disease progression over time in MS patients.
Disclosure: Julia Button has no disclosures.
Alissa Rothman has no disclosures.
Laura Balcer has received consulting fees from Biogen and Genzyme and has received research funding from Biogen.
Elliot Frohman has received speaker and consulting fees from Novartis, Genzyme, Acorda and TEVA.
Teresa Frohman has received speaker and consultant fees from Novartis, Genzyme, and Acorda.
Daniel Reich research funding from Intramural Research Program of NINDS, Myelin Repair Foundation, and Vertex Pharmaceuticals (none relevant to this abstract).
Shiv Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology, consulting fees from Axon Advisors LLC, Educational Grant Support from Novartis & Teva Neurosciences, speaking honoraria from the National Association of Managed Care Physicians, Advanced Studies in Medicine and the Family Medicine Foundation of West Virginia, and served on scientific advisory boards for Biogen-Idec, Genzyme & Novartis. He is a researcher in the OCTIMS study. He receives research funding from the Race to Erase MS and Genentech Corporation.
Peter A Calabresi has received consulting fees from Vertex, Abbvie, and Merck and has received research funding from Biogen, Novartis and MedImmune. He is co-chairman of the scientific advisory board of the OCTIMS study.