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Optical coherence tomography detects both neurodegeneration and inflammatory activity in clinically isolated syndromes suggestive of multiple sclerosis
Author(s): ,
M. Pisa
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
T. Croese
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
G. Dalla Costa
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
S. Guerrieri
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
L. Moiola
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
F. Sangalli
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
V. Martinelli
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
G. Comi
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
,
R. Furlan
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
L. Leocani
Affiliations:
San Raffaele Hospital - Vita-Salute San Raffaele University, Milan, Italy
ECTRIMS Online Library. Pisa M.
Oct 12, 2018; 228993
Marco Pisa
Marco Pisa
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Abstract: P1153

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - OCT

Introduction: Neuroretinal changes measured with optical coherence tomography (OCT) can be detected in multiple sclerosis (MS) and in clinically isolated syndromes (CIS) suggestive of MS.
Thinning of retinal nerve fibre layer (RNFL) and ganglion cell/inner plexiform layer (GCIPL) reflects neurodegenerative processes, while inner nuclear layer (INL) has been proposed as a marker of inflammation.
We aimed to investigate in CIS patients the relationship between OCT measures and other biomarkers: oligoclonal bands, CSF microvesicles (MV) count, CSF cytokines and multimodal evoked potentials (mEPs).
Methods: 111 consecutive CIS patients underwent contrast-enhanced 1.5T brain MRI, EDSS, high and low-contrast visual acuity (VA), mEPs (MEP, SEP, VEP), OCT with peripapillary RNFL and macular GCIPL segmentation. All patients had CSF sampling with oligoclonal bands and microvesicles count (MVs/uL) and, in a subgroup (N=30), CSF cytokine dosage (IL1b, 2, 4, 5, 6, 7, 8, 10, 12, 13, 17; IFNg; MCAF; MIP1b).
We used Spearman rho for non-parametric correlations and multivariate linear regression to test the relative contribution of the predictors.
Only eyes without previous optic neuritis were analysed.
Results: GCIPL and RNFL thickness correlated with visual and global disability: EDSS (r -0.3, p=0.003 and r -0.2, p=0.045 respectively), low contrast VA (r -0.25, p=0.018 and r -0.29, p=0.006). Retinal atrophy also correlated with mEPs overall (r -0.3, p=0.003 and r -0.27, p=0.008), MEP and SSEP (r -0.25, p=0.015 and r -0.24, p=0.022), number of T2 lesions (r -0.37, p< 0.001 and r -0.38, p< 0.001).
At multivariate regression, brain T2 lesion load and EDSS were the main predictors of RNFL thickness (R=0.47, p< 0.001).
INL did not correlate with disability, with OCB or with MRI contrast enhancement, but with anti-inflammatory cytokines (IL10) and MV count (r 0.43, p=0.034 and r 0.22, p=0.029 respectively); it was inversely associated with the pro-inflammatory MIP1b (r -0.55, p=0.006).
IL10 and MIP1b were predictors of INL thickness at multivariate regression (R=0.71, p< 0.003).
Conclusions: RNFL and GCL are associated with both visual pathway damage (VEP and VA), spinal cord damage (MEP-SSEP, EDSS) and brain lesions and could be considered as indicators of previous structural damage accumulation.
Retinal INL thickening is associated with the anti-inflammatory activity following MS relapses, supporting its role as a marker of ongoing immunological activation.
Disclosure: L. Leocani received honoraria for consulting services from Merck, Roche, Biogen and for speaking activities from Teva; research support from Merck, Biogen, Novartis; travel support from Merck, Roche, Biogen, Almirall.
G. Comi has received compensation for consulting services and /or for speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Celgene, Forward Pharma, Medday.
V. Martinelli reports consultancy, speaking fees and/or travel expenses from Biogen, Merck Serono, Bayer Schering, Novartis, Sanofi-Aventis, Genzyme Europe, Teva Pharmaceuticals, outside the submitted work.
F. Sangalli,L. Moiola, R. Furlan report consultancy, speaking fees and/or travel expenses from Biogen, Merck Serono, Genzyme, Novartis.
M. Pisa, T. Croese, G. Dalla Costa, S. Guerrieri has nothing to disclose.

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