Contributions
Abstract: P603
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 22 OCT
Background: Optical Coherence Tomography (OCT) is a non-invasive modality used to quantify the thickness of the retinal nerve fiber layer (RNFL). Studies have shown that both adult and pediatric patients with Multiple Sclerosis (MS) have decreased RNFL thickness compared to healthy controls.
In adult MS patients, RNFL thickness correlates with disability and disease severity measures.
Objective: To determine whether OCT values correlate with markers of disability and disease severity in pediatric MS patients.
Methods: Data was collected via retrospective chart review of 120 patients with MS at Texas Children´s Hospital. Inclusion criteria consisted of MRI, OCT and MS clinic visit performed within 12 months of each other. 32 patients met these criteria, 9 with a history of optic neuritis (ON). Correlation of average RNFL, temporal quadrant thickness, and macular thickness with Expanded Disability Status Scale (EDSS), Visual Functional System Score (VFSS), and annualized relapse rate (ARR) was measured. Patients were divided based on the presence or absence of new T2 lesions on MRI brain and spine and OCT data was compared between the two groups. In the 17 patients with 2 sets of OCT data, correlation between change in OCT values and measures of disease severity was obtained.
Results: Patients with history of ON had statistically significant lower average RNFL thickness (p: 0.03) compared to those without history of ON. Thickness of the RNFL was negatively correlated with VFSS (r2:-0.39, p: 0.04). No significant correlation was found between OCT values and EDSS, ARR, or the presence of new T2 lesions. In patients with 2 OCTs, degree of change in the OCT values did not correlate with the above measures.
Conclusions: As in previous studies, our data shows that pediatric MS patients with a history of ON have RNFL thinning. Our data importantly shows that decreased RNFL is correlated with higher VFSS, indicating more severe visual disability. However in our cohort of patients, OCT data was not predictive of disease severity or disability as measured by EDSS, ARR, or new T2 lesions. Furthermore, change in OCT values over time did not correlate with these measures. Therefore, though adult literature suggests using OCT data as a surrogate for disease severity and overall disability, our data thus far does not support a similar use of OCT data in the pediatric MS population. Our data does however support the use of RNFL thickness as a surrogate for visual disability.
Disclosure:
Nikita Malani Shukla: nothing to disclose
Timothy Lotze: nothing to disclose
Veeral Shah: nothing to disclose
Abstract: P603
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 22 OCT
Background: Optical Coherence Tomography (OCT) is a non-invasive modality used to quantify the thickness of the retinal nerve fiber layer (RNFL). Studies have shown that both adult and pediatric patients with Multiple Sclerosis (MS) have decreased RNFL thickness compared to healthy controls.
In adult MS patients, RNFL thickness correlates with disability and disease severity measures.
Objective: To determine whether OCT values correlate with markers of disability and disease severity in pediatric MS patients.
Methods: Data was collected via retrospective chart review of 120 patients with MS at Texas Children´s Hospital. Inclusion criteria consisted of MRI, OCT and MS clinic visit performed within 12 months of each other. 32 patients met these criteria, 9 with a history of optic neuritis (ON). Correlation of average RNFL, temporal quadrant thickness, and macular thickness with Expanded Disability Status Scale (EDSS), Visual Functional System Score (VFSS), and annualized relapse rate (ARR) was measured. Patients were divided based on the presence or absence of new T2 lesions on MRI brain and spine and OCT data was compared between the two groups. In the 17 patients with 2 sets of OCT data, correlation between change in OCT values and measures of disease severity was obtained.
Results: Patients with history of ON had statistically significant lower average RNFL thickness (p: 0.03) compared to those without history of ON. Thickness of the RNFL was negatively correlated with VFSS (r2:-0.39, p: 0.04). No significant correlation was found between OCT values and EDSS, ARR, or the presence of new T2 lesions. In patients with 2 OCTs, degree of change in the OCT values did not correlate with the above measures.
Conclusions: As in previous studies, our data shows that pediatric MS patients with a history of ON have RNFL thinning. Our data importantly shows that decreased RNFL is correlated with higher VFSS, indicating more severe visual disability. However in our cohort of patients, OCT data was not predictive of disease severity or disability as measured by EDSS, ARR, or new T2 lesions. Furthermore, change in OCT values over time did not correlate with these measures. Therefore, though adult literature suggests using OCT data as a surrogate for disease severity and overall disability, our data thus far does not support a similar use of OCT data in the pediatric MS population. Our data does however support the use of RNFL thickness as a surrogate for visual disability.
Disclosure:
Nikita Malani Shukla: nothing to disclose
Timothy Lotze: nothing to disclose
Veeral Shah: nothing to disclose