Contributions
Abstract: 103
Type: Young Scientific Investigators' Session
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Optic neuritis (ON) is a frequent manifestation of inflammatory disorders of the central nervous system, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). In comparison to MS-ON, NMOSD-ON is characterized by worse visual outcomes, often resulting in blindness, and more severe retinal neuro-axonal loss, as identified by optical coherence tomography (OCT). The majority of cases of NMOSD are associated with antibodies directed against aquaporin-4 (AQP4-IgG). However, antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been identified in a subset of NMOSD patients that are seronegative for AQP4-IgG. Studies comparing visual outcomes and retinal neuro-axonal integrity following AQP4-IgG and MOG-IgG associated ON are limited.
Objective: To compare visual outcomes and retinal OCT measures following ON associated with AQP4-IgG (AQP4-ON), MOG-IgG (MOG-ON) and MS (MS-ON).
Methods: 38 AQP4-ON, 13 MOG-ON, 40 MS-ON and 31 healthy control (HC) participants underwent retinal imaging with spectral-domain OCT. Monocular letter-acuity (LA) at high (100%) and low (2.5% and 1.25%) contrast was assessed. Only eyes with a history of ON greater than 3 months prior to the time of assessment were included in the analysis.
Results: AQP4-ON eyes (n=56) exhibited worse high-contrast LA (HCLA) compared to both MOG-ON (n=21; p< 0.001) and MS-ON eyes (n=47; p< 0.001). HCLA did not differ between MOG-ON and MS-ON eyes (p=0.31), however both were decreased compared to HC (p=0.004 and p=0.01 respectively). Ganglion cell + inner plexiform layer (GCIP) and retinal nerve fiber layer (RNFL) thicknesses were decreased in MOG-ON and AQP4-ON compared to MS-ON eyes (p< 0.001) but did not differ between MOG-ON and AQP4-ON eyes. Microcystic macular pathology (MMP) was found in none of the MOG-ON (0%), 12 AQP4-ON (21%) and 3 MS-ON eyes (6%). Multivariate analyses, adjusting for age, sex, race, presence of MMP, number of ON episodes, and GCIP or RNFL thickness, revealed that AQP4-ON was independently associated with lower HCLA, as compared to MOG-ON and MS-ON (p< 0.01 for all).
Conclusions: AQP4-IgG seropositivity is associated with worse visual outcomes after ON, as compared with MOG-ON and MS-ON. Importantly, this finding is independent of the presence of MMP and of the severity of GCIP and RNFL thinning, suggesting that additional pathologic processes may contribute to visual dysfunction in AQP4-ON.
Disclosure: Study Funding: This study was funded by the National Institutes of Health (5R01NS082347 to P.C.; NS-078555 to M.L. ) and National MS Society (FP-1607-24999 to E.S.; RG-1606-08768 to S.S).
Author Disclosures: Elias Sotirchos is funded by a Sylvia Lawry physician fellowship award from the National Multiple Sclerosis Society (NMSS). Angeliki Filippatou has nothing to report.
Sarah Salama has nothing to report.
Santiago Pardo has nothing to report.
Maureen Mealy receives training funding in part by Grant Number TL1 TR001078 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.
Olwen Murphy has nothing to report.
Esther Ogbuokiri has nothing to report.
Jerry Prince is a founder of Sonovex, Inc. and serves on its Board of Directors.
Michael Levy currently receives research support from: National Institutes of Health, Maryland Technology Development Corporation, Sanofi, Genzyme, Alexion, Alnylam, Shire, Acorda and Apopharma. He also received personal compensation for consultation with Alexion, Acorda, and Genzyme and he serves on the scientific advisory boards for Alexion, Acorda and Quest Diagnostics.
Peter Calabresi has received personal honorariums for consulting from Disarm Therapeutics. He is PI on research grants to Johns Hopkins from MedImmune, Annexon, and Genzyme.
Shiv Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology and has served on scientific advisory boards for Biogen-Idec, Genzyme, Genentech Corporation, EMD Serono & Novartis. He is the PI of investigator-initiated studies funded by Genentech Corporation and Biogen Idec, and received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC, a retinal imaging device developer. He is also the site investigator of a trial sponsored by MedDay Pharmaceuticals.
Abstract: 103
Type: Young Scientific Investigators' Session
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Optic neuritis (ON) is a frequent manifestation of inflammatory disorders of the central nervous system, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). In comparison to MS-ON, NMOSD-ON is characterized by worse visual outcomes, often resulting in blindness, and more severe retinal neuro-axonal loss, as identified by optical coherence tomography (OCT). The majority of cases of NMOSD are associated with antibodies directed against aquaporin-4 (AQP4-IgG). However, antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been identified in a subset of NMOSD patients that are seronegative for AQP4-IgG. Studies comparing visual outcomes and retinal neuro-axonal integrity following AQP4-IgG and MOG-IgG associated ON are limited.
Objective: To compare visual outcomes and retinal OCT measures following ON associated with AQP4-IgG (AQP4-ON), MOG-IgG (MOG-ON) and MS (MS-ON).
Methods: 38 AQP4-ON, 13 MOG-ON, 40 MS-ON and 31 healthy control (HC) participants underwent retinal imaging with spectral-domain OCT. Monocular letter-acuity (LA) at high (100%) and low (2.5% and 1.25%) contrast was assessed. Only eyes with a history of ON greater than 3 months prior to the time of assessment were included in the analysis.
Results: AQP4-ON eyes (n=56) exhibited worse high-contrast LA (HCLA) compared to both MOG-ON (n=21; p< 0.001) and MS-ON eyes (n=47; p< 0.001). HCLA did not differ between MOG-ON and MS-ON eyes (p=0.31), however both were decreased compared to HC (p=0.004 and p=0.01 respectively). Ganglion cell + inner plexiform layer (GCIP) and retinal nerve fiber layer (RNFL) thicknesses were decreased in MOG-ON and AQP4-ON compared to MS-ON eyes (p< 0.001) but did not differ between MOG-ON and AQP4-ON eyes. Microcystic macular pathology (MMP) was found in none of the MOG-ON (0%), 12 AQP4-ON (21%) and 3 MS-ON eyes (6%). Multivariate analyses, adjusting for age, sex, race, presence of MMP, number of ON episodes, and GCIP or RNFL thickness, revealed that AQP4-ON was independently associated with lower HCLA, as compared to MOG-ON and MS-ON (p< 0.01 for all).
Conclusions: AQP4-IgG seropositivity is associated with worse visual outcomes after ON, as compared with MOG-ON and MS-ON. Importantly, this finding is independent of the presence of MMP and of the severity of GCIP and RNFL thinning, suggesting that additional pathologic processes may contribute to visual dysfunction in AQP4-ON.
Disclosure: Study Funding: This study was funded by the National Institutes of Health (5R01NS082347 to P.C.; NS-078555 to M.L. ) and National MS Society (FP-1607-24999 to E.S.; RG-1606-08768 to S.S).
Author Disclosures: Elias Sotirchos is funded by a Sylvia Lawry physician fellowship award from the National Multiple Sclerosis Society (NMSS). Angeliki Filippatou has nothing to report.
Sarah Salama has nothing to report.
Santiago Pardo has nothing to report.
Maureen Mealy receives training funding in part by Grant Number TL1 TR001078 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.
Olwen Murphy has nothing to report.
Esther Ogbuokiri has nothing to report.
Jerry Prince is a founder of Sonovex, Inc. and serves on its Board of Directors.
Michael Levy currently receives research support from: National Institutes of Health, Maryland Technology Development Corporation, Sanofi, Genzyme, Alexion, Alnylam, Shire, Acorda and Apopharma. He also received personal compensation for consultation with Alexion, Acorda, and Genzyme and he serves on the scientific advisory boards for Alexion, Acorda and Quest Diagnostics.
Peter Calabresi has received personal honorariums for consulting from Disarm Therapeutics. He is PI on research grants to Johns Hopkins from MedImmune, Annexon, and Genzyme.
Shiv Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology and has served on scientific advisory boards for Biogen-Idec, Genzyme, Genentech Corporation, EMD Serono & Novartis. He is the PI of investigator-initiated studies funded by Genentech Corporation and Biogen Idec, and received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC, a retinal imaging device developer. He is also the site investigator of a trial sponsored by MedDay Pharmaceuticals.