Contributions
Abstract: P723
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Introduction: Recent data suggest that visual pathway dysfunction in MS is associated with fatigue. One of the most common symptoms of MS is optic neuritis, which can cause relative afferent pupillary defect. Therefore quantitative assessment of pupillary function may provide important information on association with fatigue in MS.
Aims: To evaluate the potential usefulness of pupillometry for assessing the magnitude of relative afferent pupillary defects, EDSS, number of previous optic neuritis attacks (PONAs), fatigue severity in RRMS patients.
Methods: We analyzed Pupillometry data (NeurOptics®NPi-200TM) 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 272 subjects (182 RRMS and 90 healthy controls). To assess the changes in case and control subjects, multiple regression with age and group as the independent variable was run. To address the effect of PONAs, an ANCOVA was run under adjustment of the covariate, i.e., the left eye or the eye with less number of PONAs. To address EDSS and fatigue, we manually categorized eyes with no PONAs into two categories of high and low scores. The two groups in addition to the age-adjusted control group were compared by ANCOVA.
Results: In multiple regressions, dichotomous variable of group statistically significantly predicted just PS and MinPS (P< .005) with Adj. R =0.17, Adj. R =0.19, respectively. In ANCOVA analysis of PONAs, there was statistically significant differences in NPI, PS, MCV, DV and CH between groups. The notable effect size belongs to CH, (p < .0005, partial η = .105). Statistical mean variations among control group and either groups of EDSS/MFIS was significant for PS and CH variable.
Conclusions: Our prospective study provides solid data that manual pupilometer (NeurOptics®NPi-200TM) is an easy to use, highly reproducible new technique to quantify the visual pathway function in patients with MS. The results suggest that MS-related symptom scales EDSS and MFIS statistically affect pupillometry results, and thereby offers a new tool for precise measurements for visual pathway function, which was recently considered to be important for the pathophysiology of fatigue in MS.
Disclosure: Prof. 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: P723
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Introduction: Recent data suggest that visual pathway dysfunction in MS is associated with fatigue. One of the most common symptoms of MS is optic neuritis, which can cause relative afferent pupillary defect. Therefore quantitative assessment of pupillary function may provide important information on association with fatigue in MS.
Aims: To evaluate the potential usefulness of pupillometry for assessing the magnitude of relative afferent pupillary defects, EDSS, number of previous optic neuritis attacks (PONAs), fatigue severity in RRMS patients.
Methods: We analyzed Pupillometry data (NeurOptics®NPi-200TM) 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 272 subjects (182 RRMS and 90 healthy controls). To assess the changes in case and control subjects, multiple regression with age and group as the independent variable was run. To address the effect of PONAs, an ANCOVA was run under adjustment of the covariate, i.e., the left eye or the eye with less number of PONAs. To address EDSS and fatigue, we manually categorized eyes with no PONAs into two categories of high and low scores. The two groups in addition to the age-adjusted control group were compared by ANCOVA.
Results: In multiple regressions, dichotomous variable of group statistically significantly predicted just PS and MinPS (P< .005) with Adj. R =0.17, Adj. R =0.19, respectively. In ANCOVA analysis of PONAs, there was statistically significant differences in NPI, PS, MCV, DV and CH between groups. The notable effect size belongs to CH, (p < .0005, partial η = .105). Statistical mean variations among control group and either groups of EDSS/MFIS was significant for PS and CH variable.
Conclusions: Our prospective study provides solid data that manual pupilometer (NeurOptics®NPi-200TM) is an easy to use, highly reproducible new technique to quantify the visual pathway function in patients with MS. The results suggest that MS-related symptom scales EDSS and MFIS statistically affect pupillometry results, and thereby offers a new tool for precise measurements for visual pathway function, which was recently considered to be important for the pathophysiology of fatigue in MS.
Disclosure: Prof. 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)