Abstract Details

Title Importance of Optical Coherence Tomography Angiography in Differential Diagnosis of NMOSD and RRMS

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-014

Objective To investigate the importance of optical coherence tomography angiography in differential diagnosis of NMOSD and RRMS.

Background Optic neuritis(ON) is a common feature of both multiple sclerosis(RRMS) and neuromyelitis optica
spectrum disorders(NMOSD), characterized with inflammation, demyelination, and axonal injury in the optic nerve. Optical coherence tomography angiography(OCTA) is a non-invasive, promising tool to assess retinal microvascular network changes, including vessel density and capillary perfusion.Recently, retinal vascular abnormalities have been reported in MS patients.However, OCTA changes in NMOSD are unknown.

Design/Methods Fourteen MS patients with 28 eyes and 9 NMOSD patients with 18 eyes were enrolled together
with 11 healthy control subjects.Out of 68 eyes, 13 were RRMS ON-, 15 were RRMS ON+,3 were NMOSD ON-,15 were NMOSD ON+,and 22 were controls.Visual acuity,visual fields,pupil reactivity, fundus, intraocular pressure, OCTA and OCT were evaluated.Superficial peripapillary and macular vessel densities,area,perimeter and circularity of foveal avascular zone(FAZ) were analyzed.Peripapillary and macular retinal nerve fiber layer(RNFL) thickness, and peripapillary RNFL symmetry, disc area, cup/disc ratio, and cup volume were calculated.Peripapillary and macular maps with segmental thickness and volumes were generated.

Results OCTA showed a statistically significant reduction in peripapillary and macular vessel densities in
NMOSD ON+ patients when compared to RRMS ON+ patients and the controls(p=0.001, p<0.001 and p=0.012, p=0.001 respectively).OCTA parameters of optic disc were similar in RRMS ON+ patients and controls.In OCT,RRMS ON+ patients had thinner temporal and average peripapillary RNFL than the controls, whereas NMOSD ON+ patients had thinner superior and inferior RFNL, in addition.

Conclusions We report significant differences between the retinal vessel densities of RRMS and NMOSD patients. These results might suggest a role for retinal vascular network alterations in the pathophysiology of NMOSD related ON,which might be a major factor affecting the clinical outcome in NMOSD that typically results in more severe RNFL thinning.OCTA might be useful in differentiating NMOSD from MS.

Authors/Disclosures
B. Irem Tiftikcioglu PRESENTER	No disclosure on file
	No disclosure on file
Fethi Idiman, MD	No disclosure on file
Egemen Idiman, MD	No disclosure on file

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