Author Of 1 Presentation
P0773 - Variation of RNFL thickness in MS patients and DMTs: a longitudinal study. (ID 1184)
Abstract
Background
The measure of retinal nerve fiber layer (RNFL) thickness by OCT is a marker of neurodegeneration. It is known that RNFL, especially in the temporal sector, is thinner in MS patients than in healthy controls and this process occurs over time. No study has explored the possible relation between RNFL thickness and the use of DMTs to date.
Objectives
To evaluate the variation of RNFL over a follow-up of 2 years and its relation with DMTs in a group of relapsing MS patients.
Methods
Patients with relapsing-remitting MS were included and underwent a spectral-domain OCT at baseline, after 6, 12 and 24 months. In patients taking DMTs, the baseline was the time of DMT initiation. Global (G), temporal (T), and papillo-macular bundle (PMB) sectors of RNFL have been measured. Age, gender, EDSS, age at onset, and DMTs taken during the study have been collected. DMTs were divided in first (interferon beta, glatiramer acetate, dimetilfumarate, teriflunomide) and second line (natalizumab, ocrelizumab, alemtuzumab, fingolimod). The variation of RNLF during the follow-up was studied by ANOVA. By linear regression we analysed the G sector variation using as variables: DMT taken for longer time during the study by each patient, demographic and clinical features.
Results
One-hundred-one patients were included (78.2%: females; mean age and mean age at onset: 41.3 years (SD:9.7) and 30.5 (SD:9.4), respectively). Seven patients did not take any DMT during the study, and one patients started interferon beta 17 month after the baseline. At baseline: 21 subjects started with a second line DMT; 72 started with a first line DMT, and 9 of them shifted to a second line after a mean time of 17.3 months (SD:7.1). An over-time reduction of all the RNFL sectors has been found both in right (G: p<0.001; T: p<0.001; PMB: p=0.041) and in left eye (G: p<0.001; T: p<0.001; PMB: p=0.002). No relation has been found between the G sector thinning and clinical and demographic features, but a trend versus less thinning in patients with second line DMT has been shown.
Conclusions
We confirmed an over-time thinning of RNFL in patients with MS, also in a short follow-up of 2 years. No clinical and demographic variables seem to influence this phenomenon. Otherwise, even if our result is only a trend, the DMTs with more impact on the inflammation appear to slow down the thinning. A wider cohort with more patients taking second line DMTs is needed to better clarify this point.