June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Association between retinal impairment and disease severity in Multiple Sclerosis
Author Affiliations & Notes
  • Santiago Ortiz-Perez
    Institut Clinic D'Oftalmologia, Hospital Clinic, Barcelona, Spain
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
  • Elena Martinez-Lapiscina
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
    Neurology, Hospital Clinic, Barcelona, Spain
  • Iñigo Gabilondo
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
    Neurology, Hospital Clinic, Barcelona, Spain
  • Elena Fraga-Pumar
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
    Neurology, Hospital Clinic, Barcelona, Spain
  • Sara Llufriu
    Neurology, Hospital Clinic, Barcelona, Spain
  • Albert Saiz
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
    Neurology, Hospital Clinic, Barcelona, Spain
  • Bernardo Sanchez-Dalmau
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
    Neurology, Hospital Clinic, Barcelona, Spain
  • Pablo Villoslada
    Institut Clinic D'Oftalmologia, Hospital Clinic, Barcelona, Spain
    Neuro-immunology, Institut Clinic d'investigacions Biomedicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
  • Footnotes
    Commercial Relationships Santiago Ortiz-Perez, None; Elena Martinez-Lapiscina, None; Iñigo Gabilondo, None; Elena Fraga-Pumar, None; Sara Llufriu, None; Albert Saiz, Novartis (F), TEVA (F), Merck-Serono (F), Biogen Idec (F), Bayer Schering (F); Bernardo Sanchez-Dalmau, None; Pablo Villoslada, Heidelberg Engineering (C), Novartis (F), Novartis (F), Roche (C), Bionure (I), Bionure (P)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2347. doi:
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      Santiago Ortiz-Perez, Elena Martinez-Lapiscina, Iñigo Gabilondo, Elena Fraga-Pumar, Sara Llufriu, Albert Saiz, Bernardo Sanchez-Dalmau, Pablo Villoslada; Association between retinal impairment and disease severity in Multiple Sclerosis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2347.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To study the association between retinal lesions, including retinal periphlebitis (RP) and microcystic macular edema (MME), and disease severity in multiple sclerosis (MS).

 
Methods
 

We studied a prospective cohort of 100 patients with MS. Neurological and ophthalmic examination as well as MRI and Optical Coherence Tomography (OCT) were done in all participants. We compared clinical features, MRI and OCT parameters among participants with and without retinopathy in our cohort. We used general lineal models to evaluate adjusted means of T1-MPRAGE total lesion volume, Retinal Never Fiber Layer (RNFL) thickness and EDSS (baseline and change after 1 year follow-up) among patients with and without RP.

 
Results
 

7 out of 100 MS patients had retinopathy, 5 had RP (5%) and 2 had MME (2%). We only identified 2 cases of MME; therefore our study was underpowered to assess the association between MME and clinic-radiological MS severity. Clinically, patients with RP had a non-significantly higher adjusted-mean of EDSS score at baseline [adjusted differences: +0. 46 95% CI (-0.49 to +1.41);p=0. 341] and EDSS progression after 1 year of follow up [adjusted differences: +0.32 95%CI(-0.03 to +0.66),p=0.072] compared to patients without retinopathy. These patients had also a significantly higher adjusted-mean of T1-MPRAGE lesion volume [adjusted differences: +10453 95%CI(+549 to +20357);p=0.039] and lower mean of RNFL thickness at baseline [adjusted differences: +13.4 95%CI(-24.4 to -2.3); p=0. 018]

 
Conclusions
 

Full ophthalmic assessment is mandatory in MS patients in order to study the visual pathway impairment and its possible relation with others impaired systems. Retinal lesions, especially RP is more frequent in MS patients with more severe disease suggesting that it can become a biomarker of disease severity. More studies are needed to establish the role of the different ophthalmic findings as possible biomarkers in MS.

 
 
Retinal periphlebitis (RP) in A and microcystic macular edema (MME) in B. A. White sheathing around the vessel next to the dark pigment changes probably due to past inflammation of the same vessel (white arrow). A’ Active RP in another patient showing several small and subtle round hemorrhages (arrows) in the peripheral retina. B. MME is shown as small, round and empty spaces in the inner nuclear layer; the red stars point the inner plexiform - retinal ganglion cells complex just above the cysts.
 
Retinal periphlebitis (RP) in A and microcystic macular edema (MME) in B. A. White sheathing around the vessel next to the dark pigment changes probably due to past inflammation of the same vessel (white arrow). A’ Active RP in another patient showing several small and subtle round hemorrhages (arrows) in the peripheral retina. B. MME is shown as small, round and empty spaces in the inner nuclear layer; the red stars point the inner plexiform - retinal ganglion cells complex just above the cysts.
 
Keywords: 759 visual impairment: neuro-ophthalmological disease • 688 retina • 550 imaging/image analysis: clinical  
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