Abstract Details

Title Association Between Serum Glial Fibrillary Acidic Protein and Retinal Structural Changes in Patients with AQP4-antibody Positive Neuromyelitis Optica Spectrum Disorder

Topic Multiple Sclerosis

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-002

Objective To investigate the association of serum glial fibrillary acidic protein (sGFAP) with parameters of astrocytic afferent visual system damage in people with clinically stable aquaporin-4 immunoglobulin G positive (AQP4-IgG⁺) neuromyelitis optica spectrum disorder (NMOSD).

Background sGFAP is suggested as a biomarker of astrocytic damage. AQP4-IgG⁺ NMOSD is an autoimmune astrocytopathy with optic neuritis (ON) as one of its leading symptoms. Nevertheless, retinal layer thinning and foveal changes also occur independently of ON due to a retinal astrocytopathy. The astrocyte-derived sGFAP is suggested as a biomarker for astrocytic damage and subclinical disease activity in NMOSD.

Design/Methods In this cross-sectional study, sGFAP was measured by single molecule array technology in 33 subjects with AQP4-IgG⁺ NMOSD in clinical remission and 16 subjects with myelin oligodendrocyte glycoprotein associated disease (MOGAD) as specificity controls. Retinal structural parameters, including peripapillary retinal nerve fiber layer (pRNFL), ganglion cell and inner plexiform layer (GCIPL) thickness and three-dimensional foveal morphometry parameters, were measured by optical coherence tomography. Functional measurements encompassed visually evoked potentials (VEP) and high/low contrast visual acuity (HCVA and LCVA, respectively). Applying linear mixed effect models, we only analyzed eyes without history of ON (AQP4-IgG⁺: N=34, MOGAD: N=11).

Results In patients with AQP4-IgG⁺ NMOSD, higher sGFAP concentrations were associated with thinner pRNFL (β=-0.41, p=0.015) and GCIPL (β=-0.56, p=0.005), foveal flattening (e.g., average pit depth: β=-0.46, p=0.013) as well as prolonged P100 VEP latency (β=0.58, p<0.001) and reduced visual acuity (LCVA: β=0.41, p=0.026; HCVA: β=0.46, p=0.015). Neither functional nor structural parameters were found to be associated with sGFAP in patients with MOGAD.

Conclusions This study suggests that sGFAP is associated with afferent visual system damage in clinically stable AQP4-IgG⁺ NMOSD, supporting its value as a highly sensitive biomarker for astrocytopathy and the hypothesis of subclinical disease activity in AQP4-IgG⁺ NMOSD.

Authors/Disclosures
Ting-Yi Lin, MD (Charité–Universitätsmedizin Berlin) PRESENTER	Dr. Lin has nothing to disclose.
	No disclosure on file
Frederike Cosima Oertel, MD (University of California, San Francisco)	The institution of Dr. Oertel has received research support from AAN. The institution of Dr. Oertel has received research support from Hertie Foundation. Dr. Oertel has received personal compensation in the range of $500-$4,999 for serving as a Recipient (Travel Grant) with ECTRIMS. Dr. Oertel has received personal compensation in the range of $500-$4,999 for serving as a Recipient (Travel Grant) with NMSS. Dr. Oertel has received personal compensation in the range of $500-$4,999 for serving as a Recipient (Travel Grant) with ACTRIMS.
	No disclosure on file
Seyedamirhosein Motamedi, PhD (Charité University Medicine Berlin)	Mr. Motamedi has nothing to disclose.
	No disclosure on file
Jens Kuhle, MD	Dr. Kuhle has nothing to disclose.
Pascal Benkert	Pascal Benkert has nothing to disclose.
Alexander U. Brandt, MD (Charite - Universitatsmedizin Berlin)	No disclosure on file
Friedemann Paul (Charite Universitatsmedizin in Berlin)	Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hoffmann-La Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol-Myers Squibb GmbH & Co. KGaA (BMS. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon Therapeutics GmbH. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Paul has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Paul has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Paul has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for sanofi. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for F&U Confirm. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb GesmbH. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MICE Service. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for VINDICO medical education. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Beijing Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sandoz Internation GmbH. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche Thailand. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche . Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology, Neuroimmunology&Neuroinflammation.
Klemens Ruprecht, MD (Klinik fur Neurologie)	Dr. Ruprecht has received research support from European Union (821283-2). Dr. Ruprecht has received research support from Merck Serono. Dr. Ruprecht has received research support from Stiftung Charite. Dr. Ruprecht has received research support from Arthur Arnstein Foundation. Dr. Ruprecht has received publishing royalties from a publication relating to health care.
	No disclosure on file

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