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Macular ganglion cell layer allows the identification of subclinical optic neuritis
Author(s): ,
M. Pengo
Affiliations:
Padua University
,
S. Miante
Affiliations:
Padua University
,
M. Puthenparampil
Affiliations:
Padova Neuroscience Center, University of Padova, Padova
,
L. Federle
Affiliations:
Ospedale San Bortolo ULSS 8 Berica, Vicenza, Italy
,
M. Saiani
Affiliations:
Padova Neuroscience Center, University of Padova, Padova
,
F. Rinaldi
Affiliations:
Padova Neuroscience Center, University of Padova, Padova
,
P. Perini
Affiliations:
Padova Neuroscience Center, University of Padova, Padova
P. Gallo
Affiliations:
Padova Neuroscience Center, University of Padova, Padova
ECTRIMS Online Library. Pengo M. Oct 12, 2018; 228885
Marta Pengo
Marta Pengo
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Abstract: P1044

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Neuro-ophthalmology

Introduction: Acute Optic Neuritis (ON) is a frequent clinical manifestation of Multiple Sclerosis (MS). However, Visual Evoked Potentials (VEPs) frequently discloses subclinical damage of optic nerve. Optical Coherence Tomography and MRI may also help to demonstrate subclinical optic nerve damage. Up to date, no study has combined VEP, OCT and the double inversion recovery (DIR) MRI sequence to disclose subclinical optic nerve involvement in MS.
Methods: Forty MS patients at disease onset and 30 matched healthy controls (HC) were enrolled in the study. Macular scans included a 1-3-6 mm rings (1-3: inner ring; 3-6: outer ring) centred on foveola. The software calculated Retinal Nerve Fyber Layer (RNFL) and Ganglion Cell Layer (GCL) volumes automatically, dividing it in superior (S), temporal (T), nasal (N) and inferior (I) for each ring.
Each subject performed VEP and MRI, which included 3D-DIR. GEE model was applied for the statistical analysis.
Results: Clinical sign and symptoms of ON were observed in 36 patients. Damage of the optic nerve was demonstrated by VEP in 40 patients and by DIR in 16.
However, only 10 patients presented clinical, VEP and MRI suggestive of ON, while two exams were positive in 23 patients (clinical history + VEP: 18 patients; VEP + DIR: 2 patients; DIR + clinical history: 3 patients). ROC analysis demonstrated that inner S-GCL thickness values had the highest AUC (81%). For this parameter ROC analysis revealed a clear cut-off of 0.3375 µm (sensitivity of 75.8%, specificity 76.9%), whose inclusion increased the number of pathological optic nerve to 9 (22.5%).
Conclusion: The evaluation of GCL thickness allowed the identification of optic nerve damage in MS patient with discordant clinical, MRI and VEP findings.
Disclosure: Pengo Marta received travel grants from Teva, Novartis and Genzyme-Sanofi.
Puthenparampil Marco received travel grant from Novartis, Almirall, Genzyme, Biogen Idec, Teva and Sanofi Aventis; he has been consultant for Genzyme and Biogen Idec. Miante Silvia reports grants from Novartis, grants from Genzyme Sanofi, grants from Biogen Italia, grants from Almirall, grants from Teva, grants from Merck Serono, outside the submitted work. Federle Lisa reports grants and personal fees from Novartis, grants and personal fees from Genzyme Sanofi, grants and personal fees from Biogen Italia, grants and personal fees from Almirall, grants and personal fees from Teva, grants and personal fees from Merck Serono, outside the submitted work. Martina Saiani received travel grants from Teva, Novartis and Genzyme-Sanofi. Rinaldi Francesca serves as an advisory board member of Biogen-Idec and has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, Teva and Bayer Schering Pharma. Perini Paola has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, and Bayer Schering Pharma and has been consultant for Merck Serono, Biogen Idec and Teva. Gallo Paolo has been a consultant for Bayer Schering, Biogen Idec, Genzyme, Merck Serono and Novartis; has received funding for travel and speaker honoraria from Merck-Serono, Biogen Idec, Sanofi-Aventis, Novartis Pharma and Bayer-Schering Pharma, Teva; has received research support from Bayer, Biogen Idec/Elan, MerkSerono, Genzyme and Teva; and has received research grant from the University of Padova, Veneto Region of Italy, the Italian Association for Multiple Sclerosis, the Italian Ministry of Public Health.

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