June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Microvascular Abnormalities and Inner Retinal Thickness in Multiple Sclerosis
Author Affiliations & Notes
  • Sarah Houston
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Ashwini Nandoskar
    Imperial College NHS Healthcare Trust, London, United Kingdom
  • Richard Nicholas
    Imperial College NHS Healthcare Trust, London, United Kingdom
  • Jeremy Chataway
    Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
  • John Greenwood
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Adam M Dubis
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships   Sarah Houston, None; Ashwini Nandoskar, None; Richard Nicholas, None; Jeremy Chataway, None; John Greenwood, None; Adam Dubis, 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, the Multiple Sclerosis Society, the Rosetrees Trust and Stoneygate Trust. JC acknowledges the UK National Institute for Health Research (NIHR) University College London Hospitals/University College London Biomedical Research Centres Funding scheme. RN acknowledges the UK National Institute for Health Research (NIHR) Imperial College/Imperial College Healthcare Biomedical Research Centres Funding scheme.
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5118. doi:
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      Sarah Houston, Ashwini Nandoskar, Richard Nicholas, Jeremy Chataway, John Greenwood, Adam M Dubis; Microvascular Abnormalities and Inner Retinal Thickness in Multiple Sclerosis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5118.

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

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Abstract

Purpose : Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease. Functional MRI studies have indicated altered brain perfusion patterns in MS patients, suggesting a possible dysfunction of microvascular architecture and flow. The purpose of this study was to assess in the retina, as a surrogate for the brain, the linkage between vascular and neural degeneration in relapsing-remitting (RR) and secondary progressive (SP) MS.

Methods : Six patients with RRMS and four patients with SPMS were imaged using SDOCT and a custom built adaptive optics scanning light ophthalmoscope (AOSLO) with confocal and split detection imaging capabilities. Automated retinal segmentation was achieved using the Iowa Reference Algorithms. Inner retinal (IR) thickness, defined as ILM to INL, was assessed using the ‘62 grid’ pattern. The superior and temporal grid regions were extracted to match AOSLO imaging locations. Microvascular images were graded on the presence or absence of capillary bolus formations, saccular/fusiform formations (SF) and hairpin loops.

Results : Two subjects did not have sufficient image quality for microvascular grading so were excluded. In the remaining patients IR thickness in the superior region was similar between the RRMS and SPMS groups; 187 µm (SD: 51.1) and 174 µm (SD: 39.3) respectively. Temporal IR thickness was 156 µm (SD: 45.5) and 152 µm (SD: 24.6) respectively. Microvascular “bolus” formations were most common in the SPMS patient group (90.6% of images) compared with 87.5% from the RRMS group. When present, SF and hairpin loops appeared in conjunction with bolus formations. SF were present at 18.8% in the SPMS and at 16.7% in the RRMS groups and hairpin loops were more common in the SPMS group at 18.8% compared to 12.5% in the RRMS group. There is a significant correlation between IR thickness and bolus formation (r2 =0.42; p=0.03) but no correlation between the number of formations and retinal thickness or MS disability (EDSS score).

Conclusions : Our pilot data suggest that the retinal microvasculature is altered in both relapsing remitting and secondary progressive MS. The similarity in their frequency suggests that this may be an early feature of the disease. Given that capillary abnormalities have previously been seen in brain sections, whether these formations are a cause of MS related disability, or an effect of degeneration, remains an interesting question requiring further study.

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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