Abstract
Purpose :
Development of predictive biomarkers of response to therapy is a priority for therapeutic optimization in multiple sclerosis (MS). The retina represents an ideal model to investigate effects of disease modifying therapies (DMTs) using non-invasive technologies such as multifocal electroretinography (mfERG) and optical coherence tomography (SD-OCT). After DMTs onset, functional changes may precede structural ones, so neurophysiological retinal response deserves further evaluation. The aim of this study was to analyze changes of first kernel mfERG responses after 12 months of oral teriflunomide treatment (14mg/day) in patients with relapsing-remitting MS (RRMS).
Methods :
We conducted a prospective open-label study in RRMS patients starting treatment with oral teriflunomide. Patients were assessed at baseline and after 12 months of follow-up. Baseline exploration consisted of monocular 2.5% low contrast letter acuity (2.5% LCLA), SD-OCT (Spectralis, Heidelberg), mfERG (Reti-Port Science, Roland Consult) and Expanded Disability Status Scale (EDSS). At 12 months of teriflunomide treatment, mfERG exam was repeated. mfERG first kernel responses included N1 wave amplitude and peak time as well as P1 wave amplitude and peak time; results were provided as mfERG sum response and sectorial responses by concentric rings (1-5).
Results :
24 subjects (75% females; mean age of 46.8 years), mild disabled (median EDSS=2.0), were included by March 2018 and completed one year of follow-up. mfERG first kernel responses changed over 12 months showing a mean amplitude increase in N1 (+1.19 nV/deg2 [+17.4%], p=0.048) and P1 (+3.55 nV/deg2 [+20.4%], p=0.006) as well as a decreased peak time in N1 wave (-0.002 ms [-6.7%], p=0.006). Considering sectorial (ring) responses, significant increases were found in N1 amplitude (ring 5) and decreases in peak time (ring 1, ring 3 and ring 4) as well as increases in P1 amplitude (ring 3, ring 4 and ring 5).
Conclusions :
After 12 months of teriflunomide oral treatment in RRMS patients, we observed significant improvement in retinal function, as revealed by increased wave amplitudes as well as decreased latencies. Considering lack of a control group, the small sample size and the variability of mfERG explorations, these results require further confirmation.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.