September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Retinal Vessel Architecture and Blood Flow in Multiple Sclerosis
Author Affiliations & Notes
  • Adam M Dubis
    UCL - Institute of Opthalmology, London, United Kingdom
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Ashwini Nandoskar
    Imperial College NHS Healthcare Trust, London, United Kingdom
  • Angelos Kalitzeos
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    UCL - Institute of Opthalmology, London, United Kingdom
  • Praveen J Patel
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    UCL - Institute of Opthalmology, London, United Kingdom
  • Joseph Carroll
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
    Biophysics; Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Alfredo Dubra
    Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
    Biophysics; Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Jeremy Chataway
    The National Hospital for Neurology and Neurosurgery, University College Foundation NHS Trust (UCLH) , London, United Kingdom
    Neuroinflammation, University College London, London, United Kingdom
  • Richard Nicholas
    Imperial College NHS Healthcare Trust, London, United Kingdom
  • Michel Michaelides
    UCL - Institute of Opthalmology, London, United Kingdom
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • John Greenwood
    UCL - Institute of Opthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships   Adam Dubis, None; Ashwini Nandoskar, None; Angelos Kalitzeos, None; Praveen Patel, None; Joseph Carroll, None; Alfredo Dubra, US Patent 8,226,236 (P); Jeremy Chataway, None; Richard Nicholas, None; Michel Michaelides, None; John Greenwood, None
  • Footnotes
    Support  The work was supported by grants from the National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust, UCL Institute of Ophthalmology, and University College London Hospitals/UCL; Berkeley Foundation; Multiple Sclerosis Trials Center; National Institutes of Health (US) grants P30EY001931, U01 EY025477, Fight For Sight (UK), Moorfields Eye Hospital Special Trustees, Moorfields Eye Charity, the Foundation Fighting Blindness (USA), Retinitis Pigmentosa Fighting Blindness, Research to Prevent Blindness (RPB), and The Wellcome Trust [099173/Z/12/Z], The Rosetrees Trust. Michel Michaelides is supported by an FFB Career Development Award.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4621. doi:
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      Adam M Dubis, Ashwini Nandoskar, Angelos Kalitzeos, Praveen J Patel, Joseph Carroll, Alfredo Dubra, Jeremy Chataway, Richard Nicholas, Michel Michaelides, John Greenwood; Retinal Vessel Architecture and Blood Flow in Multiple Sclerosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4621.

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

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Abstract

Purpose : Multiple Sclerosis (MS) is an inflammatory, neurodegenerative disease. FMRI has shown altered brain perfusion patterns in subjects with MS. Due to the difficulty in precisely probing microvascular function in the brain, we sought to assess retinal blood vessel architecture and flow in subjects with MS.

Methods : Four subjects with relapsing-remitting, one with secondary progressive MS and four age-matched controls were imaged using spectral domain optical coherence tomography (SDOCT- Bioptigen Envisu™), OCT angiography (OCTA- Optovue AngioVue™) and a custom built adaptive optics scanning light ophthalmoscope (AOSLO) with confocal and split detection imaging capabilities. Retinal thickness was assessed using macular SDOCT volumes. Superficial and deep vessel plexuses were observed over the central 6x6 mm region with OCTA. Blood vessels were imaged in foveal and parafoveal regions split detection AOSLO. Capillary erythrocyte velocity was measured in at least three vessels per ~1 deg region of interest at three foveal and parafoveal locations.

Results : MS subject total retinal (ILM to RPE) and inner retinal thickness (ILM to OPL) were below average but within 2SD of the mean. There were no qualitative differences in retinal vessel networks between controls and MS patients on OCTA. However, some capillaries in the MS patients appeared locally swollen, compared to other similarly sized capillaries, while other capillaries appeared to transit large boluses of content (Figure 1) when observed on AOSLO. Capillary blood flow was reduced in MS patients (185.0 µm/sec, 162.4 – 208.5 µm/sec) compared to normal controls (233.1 µm/sec, 201.2-277.8 µm/sec). The bolus formations and swollen capillaries were not observed in normal controls and became more prevalent with MS severity (EDSS score). Bolus formations transited more quickly (623.3 µm/sec) than erythrocytes in the same vessels (310.2 µm/sec).

Conclusions : Our limited data indicate that retinal capillaries may be altered in MS potentially leading to reduced retinal blood flow compared to age matched controls. The latter finding supports current hypotheses regarding observations from fMRI.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

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