Abstract Details

Title Tear Analysis in Radiologically Isolated Syndrome as New Tool To Predict Risk to a Clinical Conversion

Topic MS and Related Diseases

Presentation(s) P03 - (-)

Poster/Presentation
Number 236

Objective

Background BACKGROUND: In radiologically isolated syndrome (RIS), the detection of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is critical for space dissemination validation associated with magnetic resonance imaging (MRI) multiple sclerosis (MS) diagnostic criteria published by Barkhof in 1997. It gives strength to RIS diagnosis compared with other incidental white matter T2 lesions. However, lumbar puncture for CSF collection is considered relatively invasive. Previous studies in CIS ans RR MS have demonstrated applicability of OCB detection in tears to the diagnosis of MS and CIS.

Design/Methods DESIGN/METHODS: We have prospectively included patients with RIS and compared results of CSF and tear OCB detection by isoelectric focusing (IEF). Tears were collected using a Schirmer strip.

Results RESULTS: We included prospectively 45 patients. For 3 of them, samples were non analyzable due to insufficient quantity of tears. OCBs were detected in CSF for 55% (25/45) and in tears for 50% (21/42) of patients. All patients with tears OCBs had CSF OCBs. One patient had a positive CSF and negative tears.

Conclusions CONCLUSIONS: CSF OCB presence in RIS is considered to be predictive of conversion to a clinical event. Associated with spatial dissemination MRI criteria, their detection denotes a statistically significant increased conversion risk to clinical conversion. For OCB negative patients, a tears follow-up could help to early detection of CSF conversion. We suggest that tears OCB detection may replace CSF OCB detection as a diagnostic tool in patients with RIS. This would circumvent the practice of invasive lumbar puncture and probably will increase facilities for patients and neurologists to accept MRI T2 hypersignals investigations.

Authors/Disclosures
Christine Lebrun Frenay, MD, FAAN (CRCSEP Neurologie) PRESENTER	Dr. Lebrun Frenay has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Revue Neurologique. The institution of Dr. Lebrun Frenay has received research support from FRANCE SEP.
	No disclosure on file
Nicolas Collongues, MD (Hopital Civil)	Nicolas Collongues, MD has nothing to disclose.
	No disclosure on file
Patrick Hautecoeur (Centre Hospitalier Saint Philibert)	No disclosure on file
Isabella L. Simone (Insitute of Neurologist, Univerisity of Bari Italy)	No disclosure on file

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