Amsterdam UMC
Ophthalmology and Neurology

Author Of 2 Presentations

Neuro-Ophthalmology Poster Presentation

P0763 - A longitudinal study validating the optical coherence tomography inter-eye difference as a robust diagnostic test in multiple sclerosis (ID 1383)

Speakers
Presentation Number
P0763
Presentation Topic
Neuro-Ophthalmology

Abstract

Background

Dissemination in space is one of two conceptional columns on which consensus diagnostic criteria of multiple sclerosis (MS) rests. Consistently cross-sectional data has demonstrated that optical coherence tomography (OCT) can be used to reveal the inter-eye difference of retinal layers as an additional para-clinical test in this context.

Objectives

To test the validity of the inter-eye difference of retinal layers as a diagnostic test in multiple sclerosis longitudinally.

Methods

Patients with multiple sclerosis and healthy controls who were longitudinally followed up at the Multiple Sclerosis Centre Amsterdam underwent OCT assessment at baseline and two year follow-up. We calculated the inter-eye percentage difference (IEPD) for the macular ganglion-cell inner plexiform layer (mGCIPL). Previously published cut-off levels (IMSVISUAL) were used to calculate diagnostic sensitivity and specificity levels.

Results

We included 199 participants of which 39 were healthy controls (HC). Patients with multiple sclerosis either had never experienced a clinical attack of optic neuritis (Non-MSON, n=81), suffered from unilateral MSON (n=48) or bilateral MSON (n=31). Longitudinal progression on the EDSS was less marked in these groups compared to longitudinal progression of mGCIPL atrophy. At baseline the diagnostic sensitivity and specificity values for the IEPD of the mGCIPL for comparing HC with unilateral MSON were 70%/97%, and with bilateral MSON 86%/97%. At two year follow-up the respective diagnostic sensitivity and specificity levels were 71%/97% and 83%/97%.

Conclusions

The inter-eye difference of the mGCIPL could be validated as a robust para-clinical test for multiple sclerosis longitudinally. These data were based on presence of a clinical episode of either unilateral or bilateral MSON. Extension of this approach to consider asymptomatic optic nerve pathology is warranted to further increase diagnostic sensitivity levels.

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Neuro-Ophthalmology Poster Presentation

P0769 - Saccadic eye movements reflect functional connectivity of the oculomotor brain network in MS patients (ID 1108)

Speakers
Presentation Number
P0769
Presentation Topic
Neuro-Ophthalmology

Abstract

Background

Eye movement is controlled by a widespread network of cortical and subcortical areas, the oculomotor brain network, thus accurate measurement of these movements could represent a non-invasive method to reflect (dys)functioning of these interconnected areas. This is especially relevant for diseases in which network disruption is known to represent a key pathological feature, as in multiple sclerosis (MS).

Objectives

To investigate the association between saccadic eye movements and functional connectivity of the oculomotor brain network in patients with MS.

Methods

Subjects were included from the prospective Amsterdam MS cohort. A validated standardized infrared oculography protocol (DEMoNS) was used for quantifying pro-saccades and anti-saccades (reflexive and voluntary saccadic eye movements, respectively). After resting-state magnetoencephalography (MEG) measurement, data pre-processing and beamforming of the MEG data to source space, 73 oculomotor regions of the Brainnetome atlas were included based on previous literature (i.e. the FOcuS atlas). The phase lag index (PLI) was used as a measure of functional connectivity (FC) between all regions within the oculomotor network (and it’s subnetworks) for the six conventional frequency bands. The relationship between saccadic parameters and mean FC was analyzed using multivariate linear regression models adjusted for sex, age and disease type. Effect size modification by sex was additionally investigated.

Results

The 183 included patients with MS showed altered saccadic eye movements compared to the 58 included healthy controls. Regarding pro-saccades, worse saccadic eye movement performance was mainly related to a higher FC in theta and gamma bands and a lower connectivity in alpha and beta bands. Strongest relations with FC were found for peak velocity and the parietal eye field (theta band, β -2.1 E-4, p=0.006), gain and the precuneus (gamma band, β -1.3 E-4, p=0.003) and gain and the inferior frontal eye field (theta band, β -21.0 E-4, p<0.001). For anti-saccades, the strongest associations were found between the proportion of errors and the thalamus (beta band, β 8.0 E-4, p=0.006) and error of the final eye position and the precuneus (theta band, β -6.2 E-4, p=0.004). For female MS patients the proportion of errors was also strongly related to the supplementary eye field (gamma band, β 6.4 E-4, p=0.003) and for male patients the latency of a correct response to the cingulate eye field (delta band, β 5.3 E-4, p=0.006).

Conclusions

Saccadic eye movements were related to altered functional connectivity of fronto-parietal brain regions and the thalamus in patients with MS. Furthermore, there was evidence for a relevant sex difference in patterns of functional damage of the oculomotor brain network. This network approach provides an additional backing for the future use of eye movement measurement as an easy applicable tool for monitoring or predicting the disease MS.

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Presenter Of 2 Presentations

Neuro-Ophthalmology Poster Presentation

P0763 - A longitudinal study validating the optical coherence tomography inter-eye difference as a robust diagnostic test in multiple sclerosis (ID 1383)

Speakers
Presentation Number
P0763
Presentation Topic
Neuro-Ophthalmology

Abstract

Background

Dissemination in space is one of two conceptional columns on which consensus diagnostic criteria of multiple sclerosis (MS) rests. Consistently cross-sectional data has demonstrated that optical coherence tomography (OCT) can be used to reveal the inter-eye difference of retinal layers as an additional para-clinical test in this context.

Objectives

To test the validity of the inter-eye difference of retinal layers as a diagnostic test in multiple sclerosis longitudinally.

Methods

Patients with multiple sclerosis and healthy controls who were longitudinally followed up at the Multiple Sclerosis Centre Amsterdam underwent OCT assessment at baseline and two year follow-up. We calculated the inter-eye percentage difference (IEPD) for the macular ganglion-cell inner plexiform layer (mGCIPL). Previously published cut-off levels (IMSVISUAL) were used to calculate diagnostic sensitivity and specificity levels.

Results

We included 199 participants of which 39 were healthy controls (HC). Patients with multiple sclerosis either had never experienced a clinical attack of optic neuritis (Non-MSON, n=81), suffered from unilateral MSON (n=48) or bilateral MSON (n=31). Longitudinal progression on the EDSS was less marked in these groups compared to longitudinal progression of mGCIPL atrophy. At baseline the diagnostic sensitivity and specificity values for the IEPD of the mGCIPL for comparing HC with unilateral MSON were 70%/97%, and with bilateral MSON 86%/97%. At two year follow-up the respective diagnostic sensitivity and specificity levels were 71%/97% and 83%/97%.

Conclusions

The inter-eye difference of the mGCIPL could be validated as a robust para-clinical test for multiple sclerosis longitudinally. These data were based on presence of a clinical episode of either unilateral or bilateral MSON. Extension of this approach to consider asymptomatic optic nerve pathology is warranted to further increase diagnostic sensitivity levels.

Collapse
Neuro-Ophthalmology Poster Presentation

P0769 - Saccadic eye movements reflect functional connectivity of the oculomotor brain network in MS patients (ID 1108)

Speakers
Presentation Number
P0769
Presentation Topic
Neuro-Ophthalmology

Abstract

Background

Eye movement is controlled by a widespread network of cortical and subcortical areas, the oculomotor brain network, thus accurate measurement of these movements could represent a non-invasive method to reflect (dys)functioning of these interconnected areas. This is especially relevant for diseases in which network disruption is known to represent a key pathological feature, as in multiple sclerosis (MS).

Objectives

To investigate the association between saccadic eye movements and functional connectivity of the oculomotor brain network in patients with MS.

Methods

Subjects were included from the prospective Amsterdam MS cohort. A validated standardized infrared oculography protocol (DEMoNS) was used for quantifying pro-saccades and anti-saccades (reflexive and voluntary saccadic eye movements, respectively). After resting-state magnetoencephalography (MEG) measurement, data pre-processing and beamforming of the MEG data to source space, 73 oculomotor regions of the Brainnetome atlas were included based on previous literature (i.e. the FOcuS atlas). The phase lag index (PLI) was used as a measure of functional connectivity (FC) between all regions within the oculomotor network (and it’s subnetworks) for the six conventional frequency bands. The relationship between saccadic parameters and mean FC was analyzed using multivariate linear regression models adjusted for sex, age and disease type. Effect size modification by sex was additionally investigated.

Results

The 183 included patients with MS showed altered saccadic eye movements compared to the 58 included healthy controls. Regarding pro-saccades, worse saccadic eye movement performance was mainly related to a higher FC in theta and gamma bands and a lower connectivity in alpha and beta bands. Strongest relations with FC were found for peak velocity and the parietal eye field (theta band, β -2.1 E-4, p=0.006), gain and the precuneus (gamma band, β -1.3 E-4, p=0.003) and gain and the inferior frontal eye field (theta band, β -21.0 E-4, p<0.001). For anti-saccades, the strongest associations were found between the proportion of errors and the thalamus (beta band, β 8.0 E-4, p=0.006) and error of the final eye position and the precuneus (theta band, β -6.2 E-4, p=0.004). For female MS patients the proportion of errors was also strongly related to the supplementary eye field (gamma band, β 6.4 E-4, p=0.003) and for male patients the latency of a correct response to the cingulate eye field (delta band, β 5.3 E-4, p=0.006).

Conclusions

Saccadic eye movements were related to altered functional connectivity of fronto-parietal brain regions and the thalamus in patients with MS. Furthermore, there was evidence for a relevant sex difference in patterns of functional damage of the oculomotor brain network. This network approach provides an additional backing for the future use of eye movement measurement as an easy applicable tool for monitoring or predicting the disease MS.

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