Abstract Details

Title Vision as a Structural and Functional Correlate to Fatigue and Disability in Multiple Sclerosis

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P06 - (-)

Poster/Presentation
Number 018

Objective

Background BACKGROUND: Measures of visual pathway structure and function correlate with many aspects of disease in MS. The relation of clinically meaningful visual changes and axonal and neuronal loss in the retina to fatigue, a common and potentially disabling symptom in MS, and to neurologic disability has not been well established using newer spectral-domain (SD) OCT.

Design/Methods DESIGN/METHODS: Participants underwent high contrast visual acuity (VA), low contrast letter acuity (LCA at 1.25% contrast), modified fatigued impact scale (MFIS) and Expanded Disability Status Scale (EDSS). Retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GCL+IPL) were measured using time and SD OCT.

Results RESULTS: Fatigued patients had overall worse visual function (p?0.017, linear regression accounting for age) and, in the cohort that underwent segmentation, thinner GCL+IPL (mean difference 7 microns, p=0.011 accounting for age, using worst eye) compared to non-fatigued patients. Fatigued patients also had a stronger association with RNFL loss than non-fatigued patients compared to controls (11 microns, p=0.004 compared to 7.7 microns, p=0.037 accounting for age, using worst eye). Disability also correlated with RNFL thickness (partial corr = -0.28, p=0.0049 adjusted for age). A one-line decrease of VA and LCA was associated with a 3.4 and 2.6 point increases (worsening) in fatigue scores, respectively (p?0.016) and a 0.6 and 0.5 point increases in disability EDSS scores, respectively (p<0.001, linear regression, accounting for age).

Conclusions CONCLUSIONS: Fatigue and neurologic disability are associated with structural and functional visual changes. These findings further support the use of these measures in clinical trials and suggest that fatigue is an ongoing process with fatigued patients having worse outcomes than non-fatigued patients with MS.

Authors/Disclosures
Salim Chahin, MD (Washington University School of Medicine, Neurology Dept.) PRESENTER	Dr. Chahin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Chahin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Chahin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutic . The institution of Dr. Chahin has received research support from National MS Society. The institution of Dr. Chahin has received research support from BMS.
Deborah M. Miller, PhD (Cleveland Clinic Foundation)	Dr. Miller has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
Stephen Krieger, MD, FAAN (Mount Sinai Dept of Neurology)	Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Krieger has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Krieger has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cycle. The institution of Dr. Krieger has received research support from Novartis. The institution of Dr. Krieger has received research support from Bristol Myers Squibb. The institution of Dr. Krieger has received research support from Biogen. The institution of Dr. Krieger has received research support from Sanofi.
	No disclosure on file
Ari Green, MD (UCSF)	Dr. Green has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. The institution of Dr. Green has received research support from Department of Defense. The institution of Dr. Green has received research support from Department of Defense. The institution of Dr. Green has received research support from NIH. The institution of Dr. Green has received research support from NIH / NINDS. The institution of Dr. Green has received research support from NIH / NINDS. Dr. Green has received intellectual property interests from a discovery or technology relating to health care.
Peter A. Calabresi, MD, FAAN (Johns Hopkins University)	Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.
Elliot M. Frohman, MD, FAAN	Dr. Frohman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen. Dr. Frohman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Janssen. Dr. Frohman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up To Date. Dr. Frohman has received publishing royalties from a publication relating to health care.
Steven Galetta, MD, FAAN (NYU Langone Medical Center)	Dr. Galetta has nothing to disclose.
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine)	An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia.

��ɫ��

��ɫ��