June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Ophthalmological parameters could indicate the safety of nanomembrane plasmapheresis in patients with relapsing- remitting form of Multiple Sclerosis (RRMS) during remission and with Neuromyelitis Optica (NMO)
Author Affiliations & Notes
  • Peter Krasimirov Sapundzhiev
    University Eye Hospital "Prof. Pashev", Sofia, Bulgaria
  • Petja Ivanova Vassileva
    University Eye Hospital "Prof. Pashev", Sofia, Bulgaria
  • Alexander Alexandrov
    Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Science, Sofia, Bulgaria
  • Albena Momchilova
    Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Science, Sofia, Bulgaria
  • Zlatan Tsonchev
    Clinic of Neurology, University Hospital “Queen Joanna- ISUL”, Sofia, Bulgaria
  • Milka Orozova
    Clinic of Neurology, University Hospital “Queen Joanna- ISUL”, Sofia, Bulgaria
  • Footnotes
    Commercial Relationships   Peter Sapundzhiev, None; Petja Vassileva, None; Alexander Alexandrov, None; Albena Momchilova, None; Zlatan Tsonchev, None; Milka Orozova, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5119. doi:
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      Peter Krasimirov Sapundzhiev, Petja Ivanova Vassileva, Alexander Alexandrov, Albena Momchilova, Zlatan Tsonchev, Milka Orozova; Ophthalmological parameters could indicate the safety of nanomembrane plasmapheresis in patients with relapsing- remitting form of Multiple Sclerosis (RRMS) during remission and with Neuromyelitis Optica (NMO). Invest. Ophthalmol. Vis. Sci. 2017;58(8):5119.

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

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Abstract

Purpose : Our purpose is to describe the effects of the treatment with nanomembrane plasmapheresis on the ophthalmological status in patients with relapsing- remitting form of Multiple Sclerosis (RRMS) during remission and in a patient with Neuromyelitis Optica (NMO) while not experiencing an acute episode of the disease, and the correlation with the lipid peroxidase level - an oxidative stress parameter.

Methods : Two male and three female patients with RRMS and one female patient with NMO were treated with nanomembrane plasmapheresis with serum immunoglobulins and lipid proxides levels maeasurment pre- and post- treatment. Except for one, the patients were treatment- free for an average 96 months (at least 8) prior to the plasmapheresis treatment. Previous treatment included interferons for all patients and Fingolimod for two of the patients. The average plasmapheresis procedures per patient were 8.8 (5-11) for an average period of 8 (1-17) months. We evaluated several ophthalmological parameters including: best corrected visual acuity (BCVA), ophthalmological status with biomicroscopy and funduscopy, visual field and peripapillary retinal nerve fiber layer (RNFL) thickness. The follow up period was 24 months for the patient with NMO and an average 13.6 months for the patients with RRMS.

Results : All of the patients improved according to the Expanded Disability Status Scale (EDSS) after the treatment and were free of relapses during the follow up period. Reduction of both immunoglobulins and lipid peroxides levels was observed after the plasmapheresis in all patients. Neither progression, nor worsening of the BCVA and the visual field testing results were detected. The RNFL thickness showed thinning in the patient with NMO and thickening in one of the patients with MS. The thinning of the RNFL in the NMO patient, however, could be due to her comorbidity of primary open- angle glaucoma. The mean RNFL thickness in the rest of the patients remained stable.

Conclusions : The nanomembrane plasmapheresis is demonstrated as a safe treatment option for the patients with RRMS and NMO not only for the steroid- resistant acute episodes, but also as a basic one during remissions of the RRMS and non- acute episode of NMO as was demonstrated by the stability of the studied ophthalmological parameters.

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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