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Abstract Details

Determining the Best Functional and Structural Outcome to Measure the Deficits After an Episode of Optic Neuritis
Neuro-ophthalmology/Neuro-otology
P6 - Poster Session 6 (12:00 PM-1:00 PM)
5-008

Following demyelinating optic neuritis, high contrast visual acuity (HCVA) and 30-2 perimetry recovery are typically excellent. However, contrast sensitivity remains abnormal in 55.7% of affected eyes. Cross sectional studies of MS patients show low contrast visual acuity (LCVA) correlates modestly with RNFL thickness and GCL thickness. Given the profound vision deficits at presentations, and GCL thinning at outcome, we hypothesized 10-2 perimetry and LCVA deficits would be common after an episode of optic neuritis.

To assess the role of LCVA, 10-2 threshold perimetry and optical coherence tomography (OCT) measured GCL thickness as prospective biomarkers of injury after recovery from demyelinating optic neuritis.
We prospectively studied 32 eyes (32 patients, 9 men, 23 women, age 34.4 years ± 10.3) with first time acute optic neuritis and report the outcome at 6 months for LCVA 2.5% (# letters seen), GCL thickness and loss, and 10-2 mean deviation (MD).
At presentation, GCL thickness was normal (82.1µ ± 6.7, 82.81 µ ± 5.1 fellow eyes), LCVA was 1.6 ± 7.4 (28.1 fellow eye), HCVA was 28.8 ± 23. At outcome, deficits remained for LCVA in all but 4 eyes, mean 12.6 ± 15.8 (34.1 ± 10.6 in fellow eye, p=0.001), and 10-2 MD (-4.26 dB ± 3.99, -1.38 dB ± 1.39 fellow eye, p=0.01).  GCL thickness was thinned (69.6 µ ± 9.6, 82.7 µ ± 4.7 fellow eyes, p=0.001), with thinning found in 29 eyes.  GCL thickness correlated with MD (0.43, p = 0.015) but not with LCV at 6 months. Mean GCL loss (12.4 µ ± 8.4) correlated strongly with 10-2 MD (-0.60, p=0.001) and moderately with LCVA (-0.46, p=0.008).

LCVA and 10-2 MD are sensitive functional markers and GCL thickness is the best structural biomarker for measuring residual deficits due to optic neuritis.  The 10-2 MD correlates best with GCL thickness and loss.

Authors/Disclosures
Mark J. Kupersmith, MD, FAAN (Icahn School of Medicine At Mount Sinai)
PRESENTER
Dr. Kupersmith has nothing to disclose.
Sylvia Klineova, MD (Icahn School of Medicine At Mount Sinai) Dr. Klineova 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. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Klineova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.