June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Detection of corneal subbasal nerve plexus changes in patients with multiple myeloma under immunmodulative therapy by Confcal Laser Scanning Microscopy
Author Affiliations & Notes
  • Anita Koschmieder
    Ophthalmology, University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany
  • Brigitte Kragl
    Oncology, University of Rostock, Rostock, Germany
  • Stefan Diwoky
    Oncology, University of Rostock, Rostock, Germany
  • Oliver Stachs
    Ophthalmology, University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany
  • Rudolf F Guthoff
    Ophthalmology, University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany
  • Anselm G M Juenemann
    Ophthalmology, University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany
  • Christian Junghanss
    Oncology, University of Rostock, Rostock, Germany
  • Hugo Murua Escobar
    Oncology, University of Rostock, Rostock, Germany
  • Footnotes
    Commercial Relationships   Anita Koschmieder, None; Brigitte Kragl, None; Stefan Diwoky, None; Oliver Stachs, None; Rudolf Guthoff, None; Anselm Juenemann, None; Christian Junghanss, None; Hugo Escobar, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3529. doi:
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      Anita Koschmieder, Brigitte Kragl, Stefan Diwoky, Oliver Stachs, Rudolf F Guthoff, Anselm G M Juenemann, Christian Junghanss, Hugo Murua Escobar; Detection of corneal subbasal nerve plexus changes in patients with multiple myeloma under immunmodulative therapy by Confcal Laser Scanning Microscopy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3529.

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

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Abstract

Purpose : Patients with plasma cell disorders are frequently affected by peripheral neuropathy due to disease progression or therapeutic intervention. Currently, neuropathic progression is clinically surveyed by patient symptoms and testing decreased sensation to vibration with the Rydel and Seiffer tuning fork. Herein we comparatively analysed the presence of clinical neuropathic symptoms with morphological changes detected by non-invasive in vivo confocal laser scanning microscopy (CLSM) in multiple myeloma (MM) patients (n=16).

Methods : Sensible nerve function of multiple myeloma patients was evaluated by testing of feet and legs sensation to vibration with Rydell and Seiffer tuning fork, monofilament and temperature sensation as well as the Achilles tendon reflex. The assessment included the neuropathy symptom score (NNS), neuropathy deficit score (NDS) and Michigan neuropathy screening instrument (MNSI). Additionally, non-invasive CLSM of the corneal subbasal nerve plexus of one eye and a testing of corneal sensitivity of both eyes with Cochet-Bonnet Esthesiometer was performed. The patients were analysed at the time points: at Diagnosis, 3 month, 6 month, 12 month after start of therapy.

Results : In our ongoing study imaging of the corneal subbasal nerve plexus with CLSM revealed different morphological and nerve fibre changes as focal nerve fiber hypertrophy and diffuse or multiple bud-like paranerval hyperreflecivities. These changes were detected in the majority of the screened patients developing within disease course and treatment. Interestingly these changes were absent or mild at the respective initial diagnosis time points. In the same investigation period the majority of patients presented up with increased peripheral neuropathy symptoms.

Conclusions : CLSM allowed identifying different morphological patterns within the layer of corneal subbasal nerve plexus in MM patients. The observed changes appear to be unique with paraproteinemias. As a correlation of the neuropathic symptoms and imaging was possible the employment of CLSM qualifies as a methodical approach for early detection of morphological changes during MM course and treatment.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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