Contributions
Abstract: EP1318
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Structural changes in the retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) have not been described in youth with neuroinflammatory syndromes who were positive for MOG antibody in the serum (MOG+).
Objective/Aim: To describe structural changes in the anterior visual pathway in MOG+ youth.
Methods: This cross-sectional study includes consecutive youth with MOG+ neuroinflammatory syndromes (positive ≥3 months from incident demyelination; n=28, 22 female, 11.05(5.80) years old, 22 with 1+ episodes of ON, 6 without ON) followed at The Hospital for Sick Children, Canada. MOG testing was performed at a single laboratory (Oxford University Laboratories) using a cell-based assay. Comparisons were made to healthy controls (HC) (n=44, 27 female, 15.68(2.32) years old). Participants were evaluated using spectral-domain optical coherence tomography (Zeiss, Cirrus HD-OCT). For all patients the earliest OCT was analysed. However, to avoid confounding due to changes associated with acute ON, only OCT data obtained ≥3 months from an ON episode was used. Generalized linear models were fitted using generalized estimating equations to account for the correlation between pairs of eyes per participant, age and sex. Bonferroni corrections for multiple comparisons were used. Adjusted p< 0.05 was considered significant. Ethics approval was obtained.
Results: MOG+ patients were younger than controls (p< 0.001). OCT was performed 0.99(4.42) years (median(IQR)) from incident demyelination. RNFL was thinner in MOG+ than in HC eyes (median(IQR): 72(37)µm vs 100(13)µm, p< 0.001)). GCIPL was thinner in the MOG+ than in HC eyes (median(IQR): 64(20)µm vs 86(5)µm, p< 0.001).
In MOG+ patients, lower average RNFL and GCIPL thickness was observed in eyes with more episodes of ON. RNFL thickness was 25.03µm less in eyes affected by 1 ON episode (n=29) vs none (n=16), 13.60µm less in eyes affected by 2 ON episodes (n=8) vs 1, and 14.39µm less in eyes affected by 3+ ON episodes (n=3) vs 2. GCIPL thickness was 11.28µm less eyes affected by 1 ON episode vs none, 5.29µm less in eyes affected by 2 ON episodes vs 1, and 5.77µm less in eyes affected by 3+ ON episodes vs 2.
Conclusions: The presence of MOG antibodies in serum is associated with thinning of the RNFL and GCIPL layers in pediatric patients, particularly in the context of repeated episodes of ON. Future studies will assess the association of these structural changes with visual function.
Disclosure: S.A. Grover: nothing to disclose; T. Berenbaum: nothing to disclose; D. Nandamalavan: nothing to disclose; C. Yea: nothing to disclose; R. Iruthayanathan: nothing to disclose; C. Wilbur receives fellowship funding from the SickKids Research Training Centre; F. Albassam: nothing to disclose; G. Longoni receives research and training support from the National MS Society; A. Reginald: nothing to disclose; M. Wan: nothing to disclose; F. Costello: nothing to disclose; J. O´Mahony: nothing to disclose; D. Arnold: nothing to disclose; B. Banwell receives research funding from the Canadian MS Research Foundation and has served as a central MRI reviewer for Novartis and as a non-remunerated advisor on clinical trial design for Biogen IDEC, Sanofi, Genzyme, and participated as a speaker in meetings sponsored by and received consulting fees and/or grant support from: Atara Biotherapeutics, Biogen Idec, Celgene/Receptos, Genentech/Roche, GlaxoSmithKline, MAPI, Medimmune, Merck/EMD Serono, Novartis, Sanofi-Genzyme; A. Bar-Or: nothing to disclose; R.A. Marrie: nothing to disclose; D. Mabbott receives research funding from CIHR; E.A. Yeh receives research funding from the Guthy Jackson Charitable Foundation, NMSS, CMSC, OIRM, SCN, CBMH Chase an Idea, SickKids Foundation, Rare Diseases Foundation, MS Scientific Foundation (Canada), McLaughlin Centre, Mario Batali Foundation. E.A. Yeh also serves as a clinical relapse adjudicator for ACI, MOH IGSP reviewer, and has received a speaker's honorarium from Novartis.
Abstract: EP1318
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Structural changes in the retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) have not been described in youth with neuroinflammatory syndromes who were positive for MOG antibody in the serum (MOG+).
Objective/Aim: To describe structural changes in the anterior visual pathway in MOG+ youth.
Methods: This cross-sectional study includes consecutive youth with MOG+ neuroinflammatory syndromes (positive ≥3 months from incident demyelination; n=28, 22 female, 11.05(5.80) years old, 22 with 1+ episodes of ON, 6 without ON) followed at The Hospital for Sick Children, Canada. MOG testing was performed at a single laboratory (Oxford University Laboratories) using a cell-based assay. Comparisons were made to healthy controls (HC) (n=44, 27 female, 15.68(2.32) years old). Participants were evaluated using spectral-domain optical coherence tomography (Zeiss, Cirrus HD-OCT). For all patients the earliest OCT was analysed. However, to avoid confounding due to changes associated with acute ON, only OCT data obtained ≥3 months from an ON episode was used. Generalized linear models were fitted using generalized estimating equations to account for the correlation between pairs of eyes per participant, age and sex. Bonferroni corrections for multiple comparisons were used. Adjusted p< 0.05 was considered significant. Ethics approval was obtained.
Results: MOG+ patients were younger than controls (p< 0.001). OCT was performed 0.99(4.42) years (median(IQR)) from incident demyelination. RNFL was thinner in MOG+ than in HC eyes (median(IQR): 72(37)µm vs 100(13)µm, p< 0.001)). GCIPL was thinner in the MOG+ than in HC eyes (median(IQR): 64(20)µm vs 86(5)µm, p< 0.001).
In MOG+ patients, lower average RNFL and GCIPL thickness was observed in eyes with more episodes of ON. RNFL thickness was 25.03µm less in eyes affected by 1 ON episode (n=29) vs none (n=16), 13.60µm less in eyes affected by 2 ON episodes (n=8) vs 1, and 14.39µm less in eyes affected by 3+ ON episodes (n=3) vs 2. GCIPL thickness was 11.28µm less eyes affected by 1 ON episode vs none, 5.29µm less in eyes affected by 2 ON episodes vs 1, and 5.77µm less in eyes affected by 3+ ON episodes vs 2.
Conclusions: The presence of MOG antibodies in serum is associated with thinning of the RNFL and GCIPL layers in pediatric patients, particularly in the context of repeated episodes of ON. Future studies will assess the association of these structural changes with visual function.
Disclosure: S.A. Grover: nothing to disclose; T. Berenbaum: nothing to disclose; D. Nandamalavan: nothing to disclose; C. Yea: nothing to disclose; R. Iruthayanathan: nothing to disclose; C. Wilbur receives fellowship funding from the SickKids Research Training Centre; F. Albassam: nothing to disclose; G. Longoni receives research and training support from the National MS Society; A. Reginald: nothing to disclose; M. Wan: nothing to disclose; F. Costello: nothing to disclose; J. O´Mahony: nothing to disclose; D. Arnold: nothing to disclose; B. Banwell receives research funding from the Canadian MS Research Foundation and has served as a central MRI reviewer for Novartis and as a non-remunerated advisor on clinical trial design for Biogen IDEC, Sanofi, Genzyme, and participated as a speaker in meetings sponsored by and received consulting fees and/or grant support from: Atara Biotherapeutics, Biogen Idec, Celgene/Receptos, Genentech/Roche, GlaxoSmithKline, MAPI, Medimmune, Merck/EMD Serono, Novartis, Sanofi-Genzyme; A. Bar-Or: nothing to disclose; R.A. Marrie: nothing to disclose; D. Mabbott receives research funding from CIHR; E.A. Yeh receives research funding from the Guthy Jackson Charitable Foundation, NMSS, CMSC, OIRM, SCN, CBMH Chase an Idea, SickKids Foundation, Rare Diseases Foundation, MS Scientific Foundation (Canada), McLaughlin Centre, Mario Batali Foundation. E.A. Yeh also serves as a clinical relapse adjudicator for ACI, MOH IGSP reviewer, and has received a speaker's honorarium from Novartis.