Author Of 1 Presentation
PS15.03 - Optical coherence tomography in aquaporin-4-IgG positive neuromyelitis optica spectrum disorders: a collaborative multi-center study
- F. Oertel
- S. Specovius
- H. Zimmermann
- C. Chien
- S. Motamedi
- L. Cook
- M. Lana-Peixoto
- M. Fontenelle
- H. Kim
- J. Hyun
- J. Palace
- A. Roca-Fernandez
- F. Ashtari
- R. Kafieh
- L. Pandit
- A. D'Cunha
- O. Aktas
- M. Ringelstein
- E. May
- C. Tongco
- L. Leocani
- M. Pisa
- M. Radaelli
- E. Martinez-Lapiscina
- H. Stiebel-Kalish
- S. Siritho
- J. De Seze
- T. Senger
- J. Havla
- R. Marignier
- E. Nerrant
- A. Cobo Calvo
- D. Bichuetti
- I. Tavares
- N. Asgari
- K. Soelberg
- A. Altintas
- U. Tanriverdi
- A. Jacob
- S. Huda
- Z. Rimler
- Y. Mao-Draayer
- I. Soto De Castillo
- A. Green
- M. Yeaman
- T. Smith
- A. Brandt
- F. Paul
Abstract
Background
Optic neuritis (ON) is a frequent manifestation in aquaporin-4 antibody (AQP4-IgG) seropositive neuromyelitis optica spectrum disorders (NMOSD). Due to limited samples, existing optical coherence tomography (OCT) studies are inconsistent regarding retinal changes in eyes with a history of ON (NMO-ON) and without a history of ON (NMO-NON), and their functional relevance.
Objectives
The CROCTINO (Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica) project aims to reveal correlates of retinal pathology and to generate hypotheses for prospective OCT studies in NMOSD. The objective of this study was to analyze retinal changes of AQP4-IgG seropositive NMO-ON and NMO-NON eyes in an international cross-sectional OCT dataset.
Methods
Of 656 subjects, we enrolled 283 AQP4-IgG seropositive NMOSD patients and 72 healthy controls (HC) from 22 international expert centers. OCT data was acquired with Spectralis SD-OCT, Cirrus HD-OCT and Topcon 3D OCT-1. Mean thickness for the combined ganglion cell and inner plexiform layer (GCIP) and inner nuclear layer (INL) were calculated from macular volume scans. Clinical, functional and laboratory testing were performed at discretion of each center.
Results
We compared NMO-ON eyes (N = 260), NMO-NON eyes (N = 241) and HC eyes (N = 136). GCIP was reduced in NMO-ON (57.4 ± 12.2 µm) compared with NMO-NON (75.9 ± 7.7 µm; p < 0.001) and HC (81.4 ± 5.7 µm; p < 0.001). NMO-NON had thinner GCIP (p < 0.001) compared with HC. INL was thicker in NMO-ON (40.3 ± 3.9 µm) compared with NMO-NON (38.6 ± 3.9µm; p < 0.001), but not HC (39.4 ± 2.6 µm). Microcystic macular edema were visible in 6.6 % of NMOSD eyes.
Conclusions
AQP4-IgG seropositive NMOSD is characterized by a functionally relevant loss of retinal neuroaxonal content and a - probably inflammatory - increase of INL after ON. Our study further supports the existence of attack-independent damage in the visual system of patients with AQP4-IgG seropositive NMOSD.
Author Of 1 Presentation
P0086 - Highly sensitive quantitation of CXCL13 as an intrathecal biomarker in optic neuritis (ID 718)
Abstract
Background
CXCL13 chemokine is a key regulator of B cell chemotaxis and CXCL13 in cerebrospinal fluid (CSF) is of pathophysiological relevance in multiple sclerosis (MS).
Objectives
To assess the potential value of a highly sensitive CXCL13 assay in acute optic neuritis (ON) patients for prediction of MS.
Methods
A Simoa CXCL13 assay was used to measure CXCL13 in CSF and serum of two independent, treatment-naïve ON cohorts: A training cohort (TC) derived from a population-based cohort (n = 33) and a validation cohort (VC) of patients collected consecutively in line with the population study precepts (n = 30). Prospectively, 14/33 patients from the TC and 12/30 patients from the VC showed progression to MS (MS-ON). The remaining 19/33 from TC and 18/30 from VC were considered as isolated ON (ION). A group of healthy controls (HC, n = 11) were used for comparison.
Results
CXCL13 was detectable in all samples. General ON patients had higher CXCL13 than HCs (p = 0.012). In the TC, CXCL13 in MS-ON patient CSF was higher than in ION and HC (p = 0.0001 and p<0.0001, respectively). This was confirmed in the TC, where MS-ON patients too showed increased CSF CXCL13 relative to ION (p = 0.0091). Logistic regression analysis showed area under curve of 0.83 (95% confidence interval: 0.73-0.93) and an odds-ratio of 19.6 at the optimal cutoff.
Conclusions
Increased ability to detect CSF CXCL13 using the Simoa assay allowed identification of ON patients and segregated MS-ON from ION. These data indicate a promising potential of this assay, and further studies are warranted.