Contributions
Abstract: 160
Type: Scientific Session
Abstract Category: N/A
Background: Although the retina represents an unmyelinated central nervous system structure, almost all aspects of multiple sclerosis (MS) related pathology (except demyelination) may be observed in the retina. Moreover, the retina represents an opportune site to study neurodegeneration, since optic nerve affliction is virtually ubiquitous in MS. Optical coherence tomography (OCT) derived measures of retinal neurodegeneration have been shown to strongly reflect the global MS disease process. With emerging technologies, it may also be feasible to probe additional pathobiological aspects of MS in the retina, including vascular and metabolic derangements for example.
Goals: To describe advances in retinal imaging technologies that may be of utility in MS and ongoing challenges in vision reaserach.
Methods: Discussion of new retinal imaging techniques as they apply to MS, including OCT-angiography (OCT-A), retinal function imager (RFI), retinal autofluoresence (RAF), fluorescence lifetime imaging ophthalmoscophy (FLIO), macular pigment optical density (MPOD), and corneal confocal microscopy (CCM). Challenges with standardization and harmonization of visual system measures across MS studies will be examined, as well as the role of the international MS visual system consortium (IMSVISUAL) in helping overcome such challenges.
Results: MS eyes with and without a history of optic neuritis (ON) exhibit reductions in retinal vascular plexus densities, as well as reductions in retinal arteriolar and venular blood flow velocities. Retinal microvasculature measures also appear to be associated with disability estimates in MS. CCM measures are also abnormal in MS eyes, and similarly appear to be associated with disability measures. To date, there has been a paucity of RAF, MPOD and FLIO exploration in MS. Methodologies across retinal imaging studies in MS vary in regard to numerous parameters including devices used, acquisition protocols, segmentation techniques, and quality control criteria employed amongst others.
Conclusions: The armamentarium of retinal imaging techniques in MS continues to expand. Numerous emerging modalities such as RFI, OCT-A and CCM may shed light on novel aspects of MS pathobiology and may be clinically relevant. Moreover, promising retinal imaging techniques such as MPOD and FLIO warrant exploration in MS. It is important for visual system research in MS to be more standardized. IMSVISUAL may play an important role in this regard in the future.
Disclosure: Dr. 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: 160
Type: Scientific Session
Abstract Category: N/A
Background: Although the retina represents an unmyelinated central nervous system structure, almost all aspects of multiple sclerosis (MS) related pathology (except demyelination) may be observed in the retina. Moreover, the retina represents an opportune site to study neurodegeneration, since optic nerve affliction is virtually ubiquitous in MS. Optical coherence tomography (OCT) derived measures of retinal neurodegeneration have been shown to strongly reflect the global MS disease process. With emerging technologies, it may also be feasible to probe additional pathobiological aspects of MS in the retina, including vascular and metabolic derangements for example.
Goals: To describe advances in retinal imaging technologies that may be of utility in MS and ongoing challenges in vision reaserach.
Methods: Discussion of new retinal imaging techniques as they apply to MS, including OCT-angiography (OCT-A), retinal function imager (RFI), retinal autofluoresence (RAF), fluorescence lifetime imaging ophthalmoscophy (FLIO), macular pigment optical density (MPOD), and corneal confocal microscopy (CCM). Challenges with standardization and harmonization of visual system measures across MS studies will be examined, as well as the role of the international MS visual system consortium (IMSVISUAL) in helping overcome such challenges.
Results: MS eyes with and without a history of optic neuritis (ON) exhibit reductions in retinal vascular plexus densities, as well as reductions in retinal arteriolar and venular blood flow velocities. Retinal microvasculature measures also appear to be associated with disability estimates in MS. CCM measures are also abnormal in MS eyes, and similarly appear to be associated with disability measures. To date, there has been a paucity of RAF, MPOD and FLIO exploration in MS. Methodologies across retinal imaging studies in MS vary in regard to numerous parameters including devices used, acquisition protocols, segmentation techniques, and quality control criteria employed amongst others.
Conclusions: The armamentarium of retinal imaging techniques in MS continues to expand. Numerous emerging modalities such as RFI, OCT-A and CCM may shed light on novel aspects of MS pathobiology and may be clinically relevant. Moreover, promising retinal imaging techniques such as MPOD and FLIO warrant exploration in MS. It is important for visual system research in MS to be more standardized. IMSVISUAL may play an important role in this regard in the future.
Disclosure: Dr. 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.