Contributions
Abstract: 103
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Markers to monitor and predict disability progression in Multiple Sclerosis (MS) are fundamental to assess the efficacy of therapeutic interventions. We evaluated the use of optical coherence tomography (OCT) in monitoring MS activity and the advantages of the association of this technique with visual evoked potentials
Methods: we performed VEPs, OCT with measurement of retinal nerve fiber layer (RNFL) at baseline and after 2 years follow-up (fu) in 59 subjects with MS and no optic neuritis during the follow up. All patients had neurological evaluation within 3 months from OCT-VEP assessment; 51 of them also performed annual MRI with evaluation of white matter lesion load.
Results: Reduction of mean binocular RNFL thickness was correlated with the increase in the expanded disability status scale (EDSS) also controlling for baseline EDSS, baseline RNFL and disease duration (Spearmann rho -0.572, p< 0.0001; partial correlation coefficient -0.508, sig. < 0.0001). T-test between RNFL loss in patients with disability progression (n = 29; -2,56 ± 1,6 µm) compared to patients without disability progression (n = 30; -3,24 ± 2,5 µm) was significant (p ≤ 0,001; T test).
Considering the subset of 51 patients with complete radiological evaluation of disease activity during the fu, 19 patients achieved NEDA3 criteria (no relapse or confirmed disability progression or new/reactivated lesion at brain MRI) and showed a -1,08 ± 1,61µm thinning while patients who did not reach NEDA criteria had -2,92 ± 2,1µm (T-test; p = 0,002). In logistic regression model mean RNFL reduction correctly classified 78,4% of patients into NEDA group at two year (R2 0,29; p=0,007). We considered the interocular asymmetry in RNFL loss, which is supposed to mainly express pre-chiasmatic damage, and we found that it was correlated with the interocular asymmetry in P100 latency changes during follow up (r = -0,534; sig. p < 0,001 in 97 eyes with measurable cortical responses).
Conclusions: The RNFL progressive reduction, in absence of disease activity through the visual pathways, could actually be due to global neurodegenerative processes since it is associated to EDSS progression and since it shows a higher reduction rate in active MS patients. RNFL loss is also associated with latency modification, therefore VEP are useful to disentangle RNFL loss due to global neurodegenerative processes and to local subclinical inflammatory activity.
Disclosure: M. Pisa, S. Guerrieri, G. Di Maggio, S. Medaglini, U. Del Carro: has nothing to disclosure
L. Moiola received honoraria for speaking at meetings or for attending to advisory board from Sanofi-Genzyme, Biogen-Idec, Novartis and TEVA.
V. Martinelli received honoraria for consulting and speaking activities from Biogen, Merck-Serono, Bayer, TEVA, Novartis and Genzyme.
G. Comi received honoraria for consulting services and for speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, Forward Pharma
L. Leocani received personal compensation from Biogen (Advisory Board); Almirall, Novartis (travel support). Biogen (travel support ) Merck Serono (research support)
Abstract: 103
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Markers to monitor and predict disability progression in Multiple Sclerosis (MS) are fundamental to assess the efficacy of therapeutic interventions. We evaluated the use of optical coherence tomography (OCT) in monitoring MS activity and the advantages of the association of this technique with visual evoked potentials
Methods: we performed VEPs, OCT with measurement of retinal nerve fiber layer (RNFL) at baseline and after 2 years follow-up (fu) in 59 subjects with MS and no optic neuritis during the follow up. All patients had neurological evaluation within 3 months from OCT-VEP assessment; 51 of them also performed annual MRI with evaluation of white matter lesion load.
Results: Reduction of mean binocular RNFL thickness was correlated with the increase in the expanded disability status scale (EDSS) also controlling for baseline EDSS, baseline RNFL and disease duration (Spearmann rho -0.572, p< 0.0001; partial correlation coefficient -0.508, sig. < 0.0001). T-test between RNFL loss in patients with disability progression (n = 29; -2,56 ± 1,6 µm) compared to patients without disability progression (n = 30; -3,24 ± 2,5 µm) was significant (p ≤ 0,001; T test).
Considering the subset of 51 patients with complete radiological evaluation of disease activity during the fu, 19 patients achieved NEDA3 criteria (no relapse or confirmed disability progression or new/reactivated lesion at brain MRI) and showed a -1,08 ± 1,61µm thinning while patients who did not reach NEDA criteria had -2,92 ± 2,1µm (T-test; p = 0,002). In logistic regression model mean RNFL reduction correctly classified 78,4% of patients into NEDA group at two year (R2 0,29; p=0,007). We considered the interocular asymmetry in RNFL loss, which is supposed to mainly express pre-chiasmatic damage, and we found that it was correlated with the interocular asymmetry in P100 latency changes during follow up (r = -0,534; sig. p < 0,001 in 97 eyes with measurable cortical responses).
Conclusions: The RNFL progressive reduction, in absence of disease activity through the visual pathways, could actually be due to global neurodegenerative processes since it is associated to EDSS progression and since it shows a higher reduction rate in active MS patients. RNFL loss is also associated with latency modification, therefore VEP are useful to disentangle RNFL loss due to global neurodegenerative processes and to local subclinical inflammatory activity.
Disclosure: M. Pisa, S. Guerrieri, G. Di Maggio, S. Medaglini, U. Del Carro: has nothing to disclosure
L. Moiola received honoraria for speaking at meetings or for attending to advisory board from Sanofi-Genzyme, Biogen-Idec, Novartis and TEVA.
V. Martinelli received honoraria for consulting and speaking activities from Biogen, Merck-Serono, Bayer, TEVA, Novartis and Genzyme.
G. Comi received honoraria for consulting services and for speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, Forward Pharma
L. Leocani received personal compensation from Biogen (Advisory Board); Almirall, Novartis (travel support). Biogen (travel support ) Merck Serono (research support)