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Ganglion cell loss as measured by optical coherence tomography in patients with radiologically isolated syndrome predicts clinical conversion to multiple sclerosis
Author(s): ,
L. Aly
Affiliations:
Department of Neurology; Department of Experimental Neuroimmunology, Technical University of Munich; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
,
E.-M. Strauß
Affiliations:
Department of Neurology
,
C. Gasperi
Affiliations:
Department of Neurology
,
G. Lepennetier
Affiliations:
Department of Neurology
,
M.M. Hoshi
Affiliations:
Department of Neurology
,
M. Mühlau
Affiliations:
Department of Neurology
,
B. Hemmer
Affiliations:
Department of Neurology
,
T. Korn
Affiliations:
Department of Neurology; Department of Experimental Neuroimmunology, Technical University of Munich; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
B. Knier
Affiliations:
Department of Neurology; Department of Experimental Neuroimmunology, Technical University of Munich
ECTRIMS Online Library. Aly L.
Oct 12, 2018; 228992
Lilian Aly
Lilian Aly
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Abstract: P1152

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - OCT

Background: Optical coherence tomography (OCT) of the retina allows accurate quantification of different retinal layers. Retinal alterations in patients with multiple sclerosis (MS) are associated with different aspects of disease activity. Recent data suggest that thinning of the combined ganglion cell and inner plexiform layer (GCIPL) is associated with worse disease prognosis in patients with both clinically isolated syndrome and relapsing remitting MS.
Objective: To assess the association of retinal layer volumes in individuals with radiologically isolated syndrome (RIS) with the conversion to MS.
Methods: This prospective observational cohort study included 28 patients with RIS (57.1% females, age [mean ± standard deviation] 36.2 ± 11.1 years). Diagnosis of RIS was made [median (25%-75% interquartile range)] 7 (1-31) months before inclusion into the study. All patients underwent retinal OCT, cerebral magnetic resonance imaging (MRI) and clinical examination with documentation of the expanded disability status scale (EDSS) at baseline and received follow-up examinations at various time points during a follow-up time of [mean ± standard deviation] 32.4 ± 16.3 months. The primary endpoint was clinical conversion to relapsing remitting or primary progressive MS.
Results: During follow-up time, 4 patients with RIS converted to relapsing remitting MS and no patient to primary progressive MS. One patient suffered from acute optic neuritis, one patient from sensory deficits and two patients from acute myelitis. The time to conversion was [median (25%-75% interquartile range)] 26,5 (9,25 - 37) months. In Kaplan-Meyer analysis, patients with low GCIPL volumes (≤ 1.95 mm³, which was the mean value of all RIS patients) had a 12.4-fold risk (95% confidence interval 1.7 - 91.9, p=0.014) to convert to MS as compared to individuals with GCIPL volumes > 1.95 mm³. No other retinal values showed a significant association with progression to MS.
Conclusion and relevance: Low GCIPL values might be a risk factor for clinical conversion to MS in individuals with RIS.
Disclosure: LA is supported by a clinical scientist program provided by the Deutsche Forschungsgemeinschaft (SyNergy). ES has no conflict of interests. CG has no conflict of interests. GL has no conflict of interests. MMH received travel grants and honoraria from Biogen Idec, Merck Serono, and Bayer Health Care. MM has no conflict of interests. BH has served on scientific advisory boards for F. Hoffmann-La Roche Ltd, Novartis, Bayer AG, and Genentech; he has served as DMSC member for AllergyCare and TG Therapeutics; he or his institution have received speaker honoraria from Biogen Idec, Teva Neuroscience, Merck Serono, Medimmune, Novartis, Desitin, and F. Hoffmann-La Roche Ltd; his institution has received research support from Chugai Pharmaceuticals and Hoffmann-La-Roche; holds part of two patents; one for the detection of antibodies and T cells against KIR4.1 in a subpopulation of MS patients and one for genetic determinants of neutralizing antibodies to interferon β. TK has no conflict of interests. BK reports grants from the Bundesministerium für Bildung und Forschung (Kompetenznetz Multiple Sklerose KKNMS), intramural funding from the Technical University of Munich (KKF program) and a grant from Novartis unrelated to this study.

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