Abstract Details

Title Retinal Optical Coherence Tomography as a Marker in the Progression and Prognosis of Optic Neuritis in Primary Demyelinating Disorders

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 17-010

Objective

To characterize and to categorize the role of OCT in MS, MOGAD and NMOSD by performing a comparative analysis.

Background

In optic neuritis, OCT can be used to quantify the retina. Measurements of peripapillary retinal nerve fiber layer thickness, ganglion cell/ inner plexiform layer and macular volume serve as a valuable addition to aid in the management.

Design/Methods This is an observational study performed on 90 eyes of 45 consecutive patients with acute optic neuritis on long term follow up. Complete neurological and ophthalmic examinations including OCT of the peripapillary retinal nerve fibre layer with ganglion cell and inner plexiform layers were performed on both, the eye with optic neuritis and fellow eyes.

Results

Among 45 patients, an established diagnosis of MS in 32, MOG in eight and 5 in NMOSD had been made based on CSF analysis, MRI features, antibody testing and VEP. OCT showed likely myelin aggregates visible as hyper-reflective foci in MS. Both NMO-SD and MOG -ON eyes showed lower RNFL thickness (< 78um), more prominent temporal and infero-temporal quadrants as compared to MS-ON. Based on the time course, serial evaluation of OCT showed maximal thinning at 5 months after which it stabilised in 84% of patients (p=0.02). A statistically significant visual impairment with poor recovery was most prominent with NMOSD associated ON and correlated positively with visual acuity.

Conclusions Our study finds that eyes with NMO-SD and MOG showed lower RNFL thickness in terms of both average thinning and quadrant wise loss compared to MS-ON. Thinning was associated with a predominant loss of contrast sensitivity and colour vision. OCT images could serve as helpful markers in determining the diagnosis and prognosis in these patients.

Authors/Disclosures
Abhinav Mahesh, MBBS PRESENTER	Dr. Mahesh has nothing to disclose.
Lakshmi N. Ranganathan, MD, PhD, FAAN	Dr. Ranganathan has nothing to disclose.
Radha Annamalai, MD, MBBS, PhD, DNB (Ophthal)	Dr. Annamalai has nothing to disclose.
Sundar Shanmugam, MD	Dr. Shanmugam has nothing to disclose.
Philo Hazeena, MD	Dr. Hazeena has nothing to disclose.
Rithvik Ramesh, MD	Dr. Ramesh has nothing to disclose.
Deepa Avadhani, MD	Dr. Avadhani has nothing to disclose.
Hemanth Kumar Arumugam, MBBS	Dr. Arumugam has nothing to disclose.
Bagath Srinivasan Balaji, MBBS	Dr. Balaji has nothing to disclose.

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