Contributions
Abstract: EP1498
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neurodegeneration
Introduction: A major challenge in multiple sclerosis (MS) is in accurately quantifying axonal degeneration and regeneration to assess disease progression and the benefits of new therapies in clinical trials, respectively.
objectives: to evaluate CCM performance in MS over time.
Aims: to evaluate if corneal confocal microscopy (CCM), a non-invasive ophthalmic imaging modality can assess axonal degeneration and progression in MS.
methods: MS patients (n=78) were assessed at baseline and 1-year follow-up (n=15) and compared to 25 age-matched controls. The MS group was comprised of clinically isolated syndrome (CIS, n=9), relapsing-remitting MS (RRMS, n=47) and secondary progressive MS (SPMS, n=22). Participants underwent assessment of the expanded disability status scale (EDSS), quantification of retinal nerve fibre layer (RNFL) thickness and CCM to quantify corneal nerve fiber density (CNFD), branch density (CNBD) and length (CNFL).
Results: At baseline, EDSS was significantly increased in SPMS compared to CIS and RRMS (0.7±0.7v0.9±1.2v1.8±1.6v4.1±2.3,P< 0.0001). There was a significant reduction in CNFD (27.4±6.9v38.1±4.9,P< 0.0001), CNFL (15±4.1v27.9±5.5, P< 0.0001) and CNBD (39.3±21.5v92.8±34,P< 0.0001) in MS compared to controls, with no relationship to optic neuritis history or MS stage. The reduction in CCM parameters remained significant in CIS [CNFD (P< 0.01), CNBD (P< 0.0001), CNFL (P< 0.0001)], RRMS [CNFD (P< 0.0001), CNBD (P< 0.0001), CNFL (P< 0.0001)] and SPMS [CNFD (P< 0.0001), CNBD (P< 0.0001), CNFL (P< 0.0001)] compared to controls. There was a significant reduction in temporal (55.7±12.6v73.3±12.9,P< 0.0001) and temporal-inferior (120.4±22.9v139.9±9.8,P=0.0002) RNFL independent of optic neuritis history. Compared to RRMS, temporal (P=0.007) and temporal-inferior (P=0.01) RNFL was significantly lower in SPMS. EDSS was inversely correlated with CNFD (P=0.05), temporal (P=0.01) and temporal-inferior (P=0.03) RNFL. At follow-up, MS patients showed a further significant reduction in CNBD (P=0.007) and CNFL (P=0.0005) with no change in RNFL thickness, CNFD and EDSS. Controls showed no change over 12 months.
Conclusions: We show for the first time that CCM detects significant axonal degeneration in MS subtypes which appears to be progressive. A prospective study is underway to determine the diagnostic and prognostic ability of CCM in relation to retinal and quantitative brain imaging.
Disclosure: Ioannis N. Petropoulos: nothing to disclose.
Saadat Kamran: nothing to disclose.
Adnan Khan: nothing to disclose.
Georgios Ponirakis: nothing to disclose.
Naveed Akhtar: nothing to disclose.
Dirk Deleu: nothing to disclose,
Ashfaq Shuaib: nothing to disclose.
Rayaz A. Malik: nothing to disclose.
Abstract: EP1498
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neurodegeneration
Introduction: A major challenge in multiple sclerosis (MS) is in accurately quantifying axonal degeneration and regeneration to assess disease progression and the benefits of new therapies in clinical trials, respectively.
objectives: to evaluate CCM performance in MS over time.
Aims: to evaluate if corneal confocal microscopy (CCM), a non-invasive ophthalmic imaging modality can assess axonal degeneration and progression in MS.
methods: MS patients (n=78) were assessed at baseline and 1-year follow-up (n=15) and compared to 25 age-matched controls. The MS group was comprised of clinically isolated syndrome (CIS, n=9), relapsing-remitting MS (RRMS, n=47) and secondary progressive MS (SPMS, n=22). Participants underwent assessment of the expanded disability status scale (EDSS), quantification of retinal nerve fibre layer (RNFL) thickness and CCM to quantify corneal nerve fiber density (CNFD), branch density (CNBD) and length (CNFL).
Results: At baseline, EDSS was significantly increased in SPMS compared to CIS and RRMS (0.7±0.7v0.9±1.2v1.8±1.6v4.1±2.3,P< 0.0001). There was a significant reduction in CNFD (27.4±6.9v38.1±4.9,P< 0.0001), CNFL (15±4.1v27.9±5.5, P< 0.0001) and CNBD (39.3±21.5v92.8±34,P< 0.0001) in MS compared to controls, with no relationship to optic neuritis history or MS stage. The reduction in CCM parameters remained significant in CIS [CNFD (P< 0.01), CNBD (P< 0.0001), CNFL (P< 0.0001)], RRMS [CNFD (P< 0.0001), CNBD (P< 0.0001), CNFL (P< 0.0001)] and SPMS [CNFD (P< 0.0001), CNBD (P< 0.0001), CNFL (P< 0.0001)] compared to controls. There was a significant reduction in temporal (55.7±12.6v73.3±12.9,P< 0.0001) and temporal-inferior (120.4±22.9v139.9±9.8,P=0.0002) RNFL independent of optic neuritis history. Compared to RRMS, temporal (P=0.007) and temporal-inferior (P=0.01) RNFL was significantly lower in SPMS. EDSS was inversely correlated with CNFD (P=0.05), temporal (P=0.01) and temporal-inferior (P=0.03) RNFL. At follow-up, MS patients showed a further significant reduction in CNBD (P=0.007) and CNFL (P=0.0005) with no change in RNFL thickness, CNFD and EDSS. Controls showed no change over 12 months.
Conclusions: We show for the first time that CCM detects significant axonal degeneration in MS subtypes which appears to be progressive. A prospective study is underway to determine the diagnostic and prognostic ability of CCM in relation to retinal and quantitative brain imaging.
Disclosure: Ioannis N. Petropoulos: nothing to disclose.
Saadat Kamran: nothing to disclose.
Adnan Khan: nothing to disclose.
Georgios Ponirakis: nothing to disclose.
Naveed Akhtar: nothing to disclose.
Dirk Deleu: nothing to disclose,
Ashfaq Shuaib: nothing to disclose.
Rayaz A. Malik: nothing to disclose.