Contributions
Abstract: P400
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Introduction: Both neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients experience optic neuritis (ON) attacks and also a degree of pupillary light reflex abnormalities. NMOSD are characterized by devastating optic neuritis attacks causing more structural damage and visual impairment than in MS.
Objective: To differentiate pupillary response variation in RRMS from NMOSD and to evaluate the potential usefulness of manual quantitative pupillometry for assessing the magnitude of pupillary response alteration.
Methods: In this cross-sectional study, we investigated pupillometry parameters including neurological pupil index (NPi), pupil size (PS), minimum size of pupil (MinPS), percentage change of pupil size (CH), Constriction Velocity (CV), Maximum of Constriction Velocity (MCV), Dilation Velocity (DV) and latency (LAT) from 315 subjects( 182 RRMS, 23 NMOSD, 110 Healthy Control). Regarding the observed association of age with disease progression in the sample population and pupillary responses, partial correlations for each group while holding effect of age constant were run. As optic neuritis may play a significant role in pupillary response, subclassification according to ON state of eyes was also applied. Finally, linear regression was run to model the relation between EDSS and pupillary parameters.
Results: EDSS was partially correlated with almost all pupillary variables. Different groups indicated a statistically significant increase in Latency with r=0.0.468, p< 0.005 for NMOSD and r=0.171, p< 0.005 for RRMS group, and further indicated a decrease for almost all other variables such as CH (r=-0.69, p< 0.001, NMOSD; r=-0.16, p< 0.005, RRMS), NPI (r=-0.49, p< 0.001, NMOSD; r=-0.21, p< 0.001 RRMS) and MCV (r=-0.59, p< 0.005, NMOSD; r=-0.31, p=0.56, RRMS). The linear regression also revealed that age might play the role of suppressor mediator in NPI-EDSS relation.
Conclusions: The results revealed that NMOSD and RRMS exacerbate the pupillary response in line with and similar to the aging process. The degree of this exacerbation might associate to the particular pathophysiologic process of diseases as indicated by results. Furthermore, pupillary light response are affected even in the absence of ON, and the alteration of pupillary response may be expressed in terms of EDSS. These observations may set the stage for applying very simple and available methods of pupillometry in MS or NMOSD, as a routine assessment.
Disclosure: Dr. Rieckmann has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Merck, Biogen Idec, Bayer Schering Pharma, Boehringer-Ingelheim, Sanofi-Aventis, Genzyme, Novartis, Teva Pharmaceutical Industries, and Serono Symposia International Foundation.
The following authors have nothing to disclose.( Sara Samadzadeh, Roya Abolfazli, Siamak Najafinia, Christian Morcinek)
Abstract: P400
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Introduction: Both neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients experience optic neuritis (ON) attacks and also a degree of pupillary light reflex abnormalities. NMOSD are characterized by devastating optic neuritis attacks causing more structural damage and visual impairment than in MS.
Objective: To differentiate pupillary response variation in RRMS from NMOSD and to evaluate the potential usefulness of manual quantitative pupillometry for assessing the magnitude of pupillary response alteration.
Methods: In this cross-sectional study, we investigated pupillometry parameters including neurological pupil index (NPi), pupil size (PS), minimum size of pupil (MinPS), percentage change of pupil size (CH), Constriction Velocity (CV), Maximum of Constriction Velocity (MCV), Dilation Velocity (DV) and latency (LAT) from 315 subjects( 182 RRMS, 23 NMOSD, 110 Healthy Control). Regarding the observed association of age with disease progression in the sample population and pupillary responses, partial correlations for each group while holding effect of age constant were run. As optic neuritis may play a significant role in pupillary response, subclassification according to ON state of eyes was also applied. Finally, linear regression was run to model the relation between EDSS and pupillary parameters.
Results: EDSS was partially correlated with almost all pupillary variables. Different groups indicated a statistically significant increase in Latency with r=0.0.468, p< 0.005 for NMOSD and r=0.171, p< 0.005 for RRMS group, and further indicated a decrease for almost all other variables such as CH (r=-0.69, p< 0.001, NMOSD; r=-0.16, p< 0.005, RRMS), NPI (r=-0.49, p< 0.001, NMOSD; r=-0.21, p< 0.001 RRMS) and MCV (r=-0.59, p< 0.005, NMOSD; r=-0.31, p=0.56, RRMS). The linear regression also revealed that age might play the role of suppressor mediator in NPI-EDSS relation.
Conclusions: The results revealed that NMOSD and RRMS exacerbate the pupillary response in line with and similar to the aging process. The degree of this exacerbation might associate to the particular pathophysiologic process of diseases as indicated by results. Furthermore, pupillary light response are affected even in the absence of ON, and the alteration of pupillary response may be expressed in terms of EDSS. These observations may set the stage for applying very simple and available methods of pupillometry in MS or NMOSD, as a routine assessment.
Disclosure: Dr. Rieckmann has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Merck, Biogen Idec, Bayer Schering Pharma, Boehringer-Ingelheim, Sanofi-Aventis, Genzyme, Novartis, Teva Pharmaceutical Industries, and Serono Symposia International Foundation.
The following authors have nothing to disclose.( Sara Samadzadeh, Roya Abolfazli, Siamak Najafinia, Christian Morcinek)