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Temporal dynamics of intra-retinal thickness changes in clinically isolated syndrome and early multiple sclerosis
Author(s): ,
H.G. Zimmermann
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
V. Vitkova
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
I. Martorell Serra
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
A. Papadopoulou
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, University and University Hospital Basel, Basel, Switzerland
,
S. Motamedi
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
K. Gawlik
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
R.M. Giess
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
K. Ruprecht
Affiliations:
Department of Neurology
,
J. Bellmann-Strobl
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Max Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Ber
,
F. Paul
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology; Max Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Hu
A.U. Brandt
Affiliations:
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, University of California Irvine, Irvine, CA, United States
ECTRIMS Online Library. Zimmermann H. Oct 12, 2018; 228997; P1157
Hanna Gwendolyn Zimmermann
Hanna Gwendolyn Zimmermann
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Abstract: P1157

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - OCT

Introduction: Retinal neuro-axonal damage has been shown in all stages of multiple sclerosis (MS) by using optical coherence tomography (OCT). However, previous studies report inconsistent results regarding the range of thickness change in different layers.
Objectives: To describe intra-retinal thickness changes and their association to demographic features over a follow-up of up to 6 years in a well-defined cohort of patients with CIS and early MS after a first clinical event.
Aims: To understand dynamics of neuro-axonal retinal damage in early phases of the disease.
Methods: Single-center longitudinal prospective study of 113 patients (at inclusion 27 relapsing-remitting MS, 86 CIS, mean age 33±9 years, 75 female). Patients underwent OCT examination a median of 132 days [IQR 90-176] after onset and then in annual follow-up visits. OCT-derived measures include thicknesses of the peripapillary retinal nerve fiber layer (pRNFL, global and temporal sector), the macular ganglion cell and inner plexiform layer (GCIP) and the inner nuclear layer (INL). Longitudinal changes were analyzed with mixed linear models.
Results: At baseline, global (89.5±16.7 vs 100.2±10.8 µm, p= 1.15e-05) and temporal pRNFL (56.7±17.1 vs 70.3±13.1, p=2.1e-06) and GCIP (62.9±8.1 vs 70.2±6.2 µm, p= 2e-08) were reduced in eyes with a history of optic neuritis (ON), while INL after ON was slightly increased compared to eyes without ON (37.2±2.8 vs 36.4±2.3 µm, p=0.0029).
Median follow-up was 2.8 [IQR 1.7-4.1] years. Global pRNFL and GCIP exhibited significant thinning even in absence of new ON episodes during follow-up (B=-0.276, p= 0.0007, B=-0.192, p=0.0002, respectively). Temporal quadrant pRNFL became only thinner in eyes with ON during follow-up (B=-0.227, p= 1.9e-05). Male sex had a significant influence on pRNFL thinning (B=-6.911, p= 0.0067), but not on GCIP. Age had no effect on any layer. Analysis of INL thickness did not result in a significant thickness change, while graphical analysis indicated both INL thinning and thickening.
Conclusion: pRNFL and GCIP demonstrate slight but significant continuous thinning over time. However, the annual loss (0.3 µm in pRNFL and 0.2 µm in GCIP as indicated by the statistical estimate) is smaller than in most previous studies. Treatment effects, disease course and quantitative measures from magnetic resonance imaging need to be investigated for an association with dynamic retinal thickness changes and the benign thinning in this cohort.
Disclosure: HZ: received a research grant from Novartis and speaking fees from Teva.
VV: nothing to disclose
IMS: nothing to disclose
AP: consulted for Teva, received speaker-fee from Sanofi-Genzyme, travel support from Bayer AG, Teva, UCB-Pharma AG, Roche and research support from the University of Basel and the Swiss National Science Foundation.
SM: nothing to disclose
KG: nothing to disclose
RG: nothing to disclose
KR: was supported by the German Ministry of Education and Research (BMBF/KKNMS, Competence Network Multiple Sclerosis) and has received research support from Novartis and Merck Serono as well as speaking fees and travel grants from Guthy Jackson Charitable Foundation, Bayer Healthcare, Biogen Idec, Merck Serono, sanofi-aventis/Genzyme, Teva Pharmaceuticals, Roche and Novartis.
JBS: has received travel grants and speaking fees from Bayer Healthcare, Biogen Idec, Merck Serono, sanofi-aventis/Genzyme, Teva Pharmaceuticals, and Novartis.
FP receives funding from the German Research Foundation (DFG Exc 257) and reports research grants and speaker honoraria from Bayer, Teva, Genzyme, Merck, Novartis, MedImmune and is member of the steering committee of the OCTIMS study (Novartis).
AUB is cofounder and shareholder of Motognosis and Nocturne. He is named as inventor on several patent applications regarding MS serum biomarkers, OCT image analysis and perceptive visual computing.

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