Retinal Nerve Fiber Layer (RNFL) and Ganglion Cell Inner Plexiform Layer (GCIPL) in Persistently Myelin Oligodendrocyte Glycoprotein Antibody Positive Youth (P3.330)

2018 
Objective: To describe structural changes in the anterior visual pathway in persistently MOGab+ (Myelin Oligodendrocyte antibody positive) youth. Background: Structural changes in the RNFL and GCIPL have not been described in youth with persistent MOGab+ status. Design/Methods: This cross-sectional study includes consecutive youth with neuroinflammatory syndromes who were persistently MOGab+ (positive ≥3 months from incident demyelination) (n=24, 19F) followed at The Hospital for Sick Children, Toronto, Ontario, Canada. MOG testing was performed at a single laboratory (Oxford University Laboratories) using a cell-based assay at disease onset and ≥3 months after onset. Comparisons were made to healthy controls (HC) (n=32, 21F). Subjects were evaluated with a standardized visual battery that included spectral-domain optical coherence tomography (Zeiss, Cirrus HD-OCT). In patients, OCTs included were not within 3 months of an ON episode. Mann-Whitney U tests were used with a Bonferroni corrected p Results: OCT was performed a mean 2.62±2.88 years from incident demyelination. Average age at OCT was MOGab+: 11.58±3.72 and HC: 15.23±2.14. RNFL was thinner in MOGab+ patients than in HCs (median(IQR): 70.5(33)μm and 103.5(14)μm, p Both RNFL and GCIPL decreased with each episode of ON in MOG+ youth’s eyes. RNFL average decrease was 24.6μm after one event (n=21), 9.7μm after the second (n=8) and 16.1μm after 3+ events (n=4). GCIPL average decrease was 10.7μm after one event (n=19), 4.5μm after the second (n=6) and 1.8μm after 3+ events (n=4). Conclusions: Both RNFL and GCIPL decrease markedly with each ON episode and are significantly thinner than HC in youth with MOGab+ disease, with most marked reduction after first ON event. Future studies will assess the association of these structural changes with visual function. Study Supported by: This study was supported by the Ontario Institute of Regenerative Medicine, Stem Cell Network, MS Society of Canada, Multiple Sclerosis Scientific Research Foundation, SickKids Research Institute and The Hospital for Sick Children Foundation. Disclosure: Dr. Grover has nothing to disclose. Dr. Yea has nothing to disclose. Dr. Berenbaum has nothing to disclose. Dr. Nandamalavan has nothing to disclose. Dr. Iruthayanathan has nothing to disclose. Dr. Wilbur has nothing to disclose. Dr. Albassam has nothing to disclose. Dr. Longoni has nothing to disclose. Dr. Reginald has nothing to disclose. Dr. Wan has nothing to disclose. Dr. Costello has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Clene and EMD Serono. Dr. O9Mahony has nothing to disclose. Dr. Arnold has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Acorda, Biogen, F. Hoffmann-La Roche Ltd, MedDay, MedImmune, Mitsubishi, Novartis, Receptos/Celgene, Sanofi-Aventis. Dr. Arnold has received compensation for serving on the Board of Directors of NeuroRx Research. Dr Banwell has nothing to disclose. Dr. Bar-Or has nothing to disclose. Dr Marrie has nothing to disclose. Dr. Mabbott has nothing to disclose. Dr. Yeh has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Juno Therapeutics, Novartis, ACI. Dr. Yeh has received research support from Teva, unrestricted educational funds for educational symposium.
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