Abstract Details

Title Optic Nerve Head Component of the Multifocal Electroretinogram in MS Optic Neuropathy: A Pathophysiologic Signature of Translaminar Demyelination

Topic MS and Related Diseases

Presentation(s) P05 - (-)

Poster/Presentation
Number 174

Objective

Background BACKGROUND: The retinal ganglion cell axons exit the eye through the lamina cribrosa, anatomically demarcating the transition from unmyelinated to myelinated axons, with axonal transmission properties thereby transformed from membrane to saltatory conduction.

Design/Methods DESIGN/METHODS: We utilized mfERG techniques to generate the ONHC, and evaluated the number of abnormal or absent responses in relation to abnormalities on low contrast letter acuity, Humphrey automated perimetry, the presence of optic disc pallor, thinning of the retinal nerve fiber layer as measured by OCT, abnormal amplitude and timing metrics on high and low contrast pattern-reversal mfVEPs, and abnormal pupillary metrics, as measured by binocular infrared pupillometry. We evaluated normal subjects and MS patients with evidence of unilateral or bilateral optic neuropathy.

Results RESULTS: As the number of abnormal or absent mfERG generated ONHC responses increased, we observed commensurate and homolateral worsening on low contrast letter acuity, RNFL thickness, the presence of optic disc pallor, greater Humphrey automated perimetry mean deviation scores, more severe amplitude attenuation and prolonged timing responses on mfVEP, and the objective presence of a relative afferent pupillary defect (RAPD).

Conclusions CONCLUSIONS: To our knowledge, this work represents the first demonstration of abnormal mfERG generated ONHC responses, in MS eyes with evidence of validated structural and functional derangements within the anterior visual system. Abnormalities of mfERG generated ONHC responses signify a new pathophysiologic signature of MS related optic neuropathy, which may have utility to both detect and monitor neuroprotective or even restorative effects of novel therapies.

Authors/Disclosures
Teresa Frohman, PA (Frohman & Frohman, PLLC) PRESENTER	No disclosure on file
Zane Schnurmann	No disclosure on file
	No disclosure on file
Shin C. Beh, MD, FAAN (Beh Center for Vestibular & Migraine Disorders)	Dr. Beh has received publishing royalties from a publication relating to health care.
Amy Conger (UTSouthwestern Medical Center)	No disclosure on file
Darrel Conger (UT Southwestern Medical Center)	No disclosure on file
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.
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.
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.
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.

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