Abstract Details

Title Vitreomacular Interface Abnormalities in Multiple Sclerosis; A Novel Signature of Disability

Topic Multiple Sclerosis

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-013

Objective To investigate the clinical (expanded disability status scale [EDSS] and visual function [VF]) measures, and retinal layer thickness differences between PwMS with (VMIA+) and without VMIAs (VMIA-).

Background Optical coherence tomography (OCT) allows high-resolution visualization of the retina, including vitreomacular interface abnormalities (VMIAs), such as epiretinal membranes. Correlations between blood-retinal barrier (BRB) dysfunction and VMIAs exist. Since BRB disruption may occur in multiple sclerosis (MS), elucidating VMIAs’ clinical relevance in people with MS (PwMS) is of interest, and remains largely unexplored.

Design/Methods In this cross-sectional study, 1463 PwMS (2926 eyes) underwent Cirrus HD-OCT imaging, with automated macular layer segmentation. VMIA presence was recorded. The VMIA+ and VMIA- groups were age and sex matched. EDSS, VF, and retinal layer thicknesses were analyzed using linear regression. Odds ratios (ORs) were estimated using logistic regression.

Results

VMIAs were found in 95 PwMS (prevalence = 6.5%). The mean age and sex distribution of the VMIA+ (60.2 years, 72% female) and VMIA- (57.5 years, 79% female) cohorts were comparable. VMIA presence was associated with higher EDSS (difference 0.7, CI: 0.1-1.4, p=0.03), with the odds of having an EDSS>4 2.2 times higher in VMIA+, as compared to VMIA- (CI=1.21-4.16, p=0.01) PwMS. Inner nuclear layer (INL), outer nuclear layer (ONL), and retinal pigment epithelium (RPE) thicknesses were -0.98 µm (p=0.05), -2.84 µm(p=0.002) and -0.76 µm(p=0.001) respectively lower in the VMIA+ cohort. VF outcomes were similar between the groups.

Conclusions Our findings suggest VMIAs may identify an MS phenotype associated with greater disability, that is unrelated to visual dysfunction. Retinal inflammation disrupting BRB may activate Müller glia, potentially explaining why VMIA presence in PwMS correlate with greater disability. Müller glia in the INL and RPE cells may potentially migrate, possibly explaining INL and RPE thickness reductions in PwMS with VMIAs. Furthermore, disrupting the highly susceptible photoreceptors by VMIAs might reduce ONL thickness.

Authors/Disclosures
Hussein Moussa, MD PRESENTER	Dr. Moussa has nothing to disclose.
Grigorios Kalaitzidis, MD (Boston University Medical Center)	Mr. Kalaitzidis has nothing to disclose.
Henrik Ehrhardt, MBBCh (Rutgers - Robert Wood Johnson Medical School)	Henrik Ehrhardt has nothing to disclose.
Olwen Murphy, MD (Johns Hopkins Hospital)	Dr. Murphy has nothing to disclose.
Eleni Vasileiou, MD (Mount Sinai)	Dr. Vasileiou has nothing to disclose.
	No disclosure on file
Kathryn Fitzgerald, PhD (Johns Hopkins University)	Dr. Fitzgerald has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Setpoint Medical. The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.
	No disclosure on file
	No disclosure on file
Scott D. Newsome, DO, FAAN (Johns Hopkins Hospital)	Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Newsome has received research support from Biogen. The institution of Dr. Newsome has received research support from Genentech/Roche. The institution of Dr. Newsome has received research support from Department of Defense. The institution of Dr. Newsome has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Newsome has received research support from National MS Society. The institution of Dr. Newsome has received research support from Lundbeck. The institution of Dr. Newsome has received research support from Sanofi. The institution of Dr. Newsome has received research support from Kyverna Therapeutics. Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving as a Lead PI for Clinical Trial with Roche.
Elias S. Sotirchos, MD (Johns Hopkins University)	Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Sotirchos has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Sotirchos has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Sotirchos has received research support from National Institutes of Health. The institution of Dr. Sotirchos has received research support from National Multiple Sclerosis Society. The institution of Dr. Sotirchos has received research support from Sumaira Foundation. The institution of Dr. Sotirchos has received research support from Genentech. The institution of Dr. Sotirchos has received research support from UCB. The institution of Dr. Sotirchos has received research support from Astoria Biologica. The institution of Dr. Sotirchos has received research support from Ad Scientiam. The institution of Dr. Sotirchos has received research support from Alexion. The institution of Dr. Sotirchos has received research support from Corevitas. Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving as a Ad Hoc Reviewer with National Institutes of Health.
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.
	No disclosure on file
Shiv Saidha, MD (Johns Hopkins)	Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Setpoint Medical. Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ReWind Therapeutics. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Clene Pharmaceuticals. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal ETC. Dr. Saidha has stock in June Brain. Dr. Saidha has stock in Lapix Therapeutics. The institution of Dr. Saidha has received research support from Biogen. The institution of Dr. Saidha has received research support from Genentech. The institution of Dr. Saidha has received research support from Novartis. The institution of Dr. Saidha has received research support from Lapix Therapeutics. The institution of Dr. Saidha has received research support from Novartis.

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