Contributions
Abstract: P721
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Objective: To determine if an association exists between age of onset and severity of visual impairment in patients with neuromyelitis optica (NMO)
Background: NMO is a disabling autoimmune disease of the central nervous system. Knowledge on early onset NMO is sparse. Disability is attack-related. Identifying higher risk patients is important in prevention of disability accumulation.
Methods: Demographics, clinical characteristics and MRI findings were obtained from medical records at last neurological evaluation. Patients were classified as having severe visual impairment (SVI) if visual acuity (VA) ≤ 20/200 in ≥ 1 eye at last visual assessment Effect of age of onset on severity of visual outcome was evaluated using both linear and logistic regression and adjusted to disease duration.
Results: Fifty-one patients were included, 20 (39.2%) had SVI. Median age of onset was 29 years (16-40) and current age was 43 (24-53). The SVI group had earlier age of onset than the non-SVI group (median 16.5 vs. 36.0, p< 0.001). Significant association was observed between early age of onset and worse VA of better and worse eye (duration of disease-adjusted Spearman correlation coefficient of 0.40 for worse eye (p=0.004) and -0.42 for better eye (p=0.002)). 68.8% of patients had SVI when age of onset was £ 18 years (n=16), 33.3% when 19 to 36 years (n=18), and 17.7% when ³ 37 years (n=17) (p trend=0.003). Using a linear regression model, age of onset explained more variation on acuity than duration of disease (Standardized coefficient β= -0.42, p=0.002 vs. β=0.23, p=0.07). Using a logistic regression model, adjusted OR of SVI was 0.92 (95% CI: 0.87-0.98, p=0.006) for age of onset and 1.11 (1.01-1.21, p=0.02) for disease duration. AUC was similar for AOO (0.78) and disease duration (0.70). Optic nerve MRI abnormalities were more frequently observed in patients < 25 years (71.4% vs. 27.8%, p=0.005)
Conclusions: Early age of onset may predict worse visual outcome in patients with NMO. We are working on a larger cohort to enhance predictors of VA disability in NMO.
Disclosure: Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL. Hong Li has nothing to disclose. Megan Seays has nothing to disclose. Jeffrey Cohen received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Mult Scler J - ETC. Mary Rensel serves as a consultant or speaker for Biogen, Teva, Genzyme and Novartis. She receives grant funding from NMSS.
Abstract: P721
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Objective: To determine if an association exists between age of onset and severity of visual impairment in patients with neuromyelitis optica (NMO)
Background: NMO is a disabling autoimmune disease of the central nervous system. Knowledge on early onset NMO is sparse. Disability is attack-related. Identifying higher risk patients is important in prevention of disability accumulation.
Methods: Demographics, clinical characteristics and MRI findings were obtained from medical records at last neurological evaluation. Patients were classified as having severe visual impairment (SVI) if visual acuity (VA) ≤ 20/200 in ≥ 1 eye at last visual assessment Effect of age of onset on severity of visual outcome was evaluated using both linear and logistic regression and adjusted to disease duration.
Results: Fifty-one patients were included, 20 (39.2%) had SVI. Median age of onset was 29 years (16-40) and current age was 43 (24-53). The SVI group had earlier age of onset than the non-SVI group (median 16.5 vs. 36.0, p< 0.001). Significant association was observed between early age of onset and worse VA of better and worse eye (duration of disease-adjusted Spearman correlation coefficient of 0.40 for worse eye (p=0.004) and -0.42 for better eye (p=0.002)). 68.8% of patients had SVI when age of onset was £ 18 years (n=16), 33.3% when 19 to 36 years (n=18), and 17.7% when ³ 37 years (n=17) (p trend=0.003). Using a linear regression model, age of onset explained more variation on acuity than duration of disease (Standardized coefficient β= -0.42, p=0.002 vs. β=0.23, p=0.07). Using a logistic regression model, adjusted OR of SVI was 0.92 (95% CI: 0.87-0.98, p=0.006) for age of onset and 1.11 (1.01-1.21, p=0.02) for disease duration. AUC was similar for AOO (0.78) and disease duration (0.70). Optic nerve MRI abnormalities were more frequently observed in patients < 25 years (71.4% vs. 27.8%, p=0.005)
Conclusions: Early age of onset may predict worse visual outcome in patients with NMO. We are working on a larger cohort to enhance predictors of VA disability in NMO.
Disclosure: Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL. Hong Li has nothing to disclose. Megan Seays has nothing to disclose. Jeffrey Cohen received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Mult Scler J - ETC. Mary Rensel serves as a consultant or speaker for Biogen, Teva, Genzyme and Novartis. She receives grant funding from NMSS.