TY - JOUR
T1 - Association of Spectral-Domain OCT With Long-term Disability Worsening in Multiple Sclerosis
AU - Lambe, Jeffrey
AU - Fitzgerald, Kathryn C.
AU - Murphy, Olwen C.
AU - Filippatou, Angeliki G.
AU - Sotirchos, Elias S.
AU - Kalaitzidis, Grigorios
AU - Vasileiou, Elena
AU - Pellegrini, Nicole
AU - Ogbuokiri, Esther
AU - Toliver, Brandon
AU - Luciano, Nicholas J.
AU - Davis, Simidele
AU - Fioravante, Nicholas
AU - Kwakyi, Ohemaa
AU - Risher, Hunter
AU - Crainiceanu, Ciprian M.
AU - Prince, Jerry L.
AU - Newsome, Scott D.
AU - Mowry, Ellen M.
AU - Saidha, Shiv
AU - Calabresi, Peter A.
N1 - Funding Information:
This study was funded by MIH (5R01NS082347-02 [to P.A.C.]), National Multiple Sclerosis Society (TR 3760-A-3 [to P.A.C.] and RG-1606-08,768 [to S.S.]) and Race to Erase MS (to S.S.).
Publisher Copyright:
© American Academy of Neurology.
PY - 2021/4/20
Y1 - 2021/4/20
N2 - Objective To evaluate whether a retinal spectral-domain optical coherence tomography (SD-OCT) assessment at baseline is associated with long-term disability worsening in people with multiple sclerosis (PwMS), we performed SD-OCT and Expanded Disability Status Scale (EDSS) assessments among 132 PwMS at baseline and at a median of 10 years later.MethodsIn this prospective, longitudinal study, participants underwent SD-OCT, EDSS, and visual acuity (VA) assessments at baseline and at follow-up. Statistical analyses were performed using generalized linear regression models, adjusted for age, sex, race, multiple sclerosis (MS) subtype, and baseline disability. We defined clinically meaningful EDSS worsening as an increase of ≥2.0 if baseline EDSS score was <6.0 or an increase of ≥1.0 if baseline EDSS score was ≥6.0.ResultsA total of 132 PwMS (mean age 43 years; 106 patients with relapsing-remitting MS) were included in analyses. Median duration of follow-up was 10.4 years. In multivariable models excluding eyes with prior optic neuritis, relative to patients with an average baseline ganglion cell + inner plexiform layer (GCIPL) thickness ≥70 µm (the mean GCIPL thickness of all eyes at baseline), an average baseline GCIPL thickness <70 µm was associated with a 4-fold increased odds of meaningful EDSS worsening (adjusted odds ratio [OR] 3.97, 95% confidence interval [CI] 1.24-12.70; p = 0.02) and an almost 3-fold increased odds of low-contrast VA worsening (adjusted OR 2.93, 95% CI 1.40-6.13; p = 0.04).ConclusionsLower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS. Accordingly, SD-OCT at a single time point may help guide therapeutic decision-making among individual PwMS.Classification of EvidenceThis study provides Class I evidence that lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS.
AB - Objective To evaluate whether a retinal spectral-domain optical coherence tomography (SD-OCT) assessment at baseline is associated with long-term disability worsening in people with multiple sclerosis (PwMS), we performed SD-OCT and Expanded Disability Status Scale (EDSS) assessments among 132 PwMS at baseline and at a median of 10 years later.MethodsIn this prospective, longitudinal study, participants underwent SD-OCT, EDSS, and visual acuity (VA) assessments at baseline and at follow-up. Statistical analyses were performed using generalized linear regression models, adjusted for age, sex, race, multiple sclerosis (MS) subtype, and baseline disability. We defined clinically meaningful EDSS worsening as an increase of ≥2.0 if baseline EDSS score was <6.0 or an increase of ≥1.0 if baseline EDSS score was ≥6.0.ResultsA total of 132 PwMS (mean age 43 years; 106 patients with relapsing-remitting MS) were included in analyses. Median duration of follow-up was 10.4 years. In multivariable models excluding eyes with prior optic neuritis, relative to patients with an average baseline ganglion cell + inner plexiform layer (GCIPL) thickness ≥70 µm (the mean GCIPL thickness of all eyes at baseline), an average baseline GCIPL thickness <70 µm was associated with a 4-fold increased odds of meaningful EDSS worsening (adjusted odds ratio [OR] 3.97, 95% confidence interval [CI] 1.24-12.70; p = 0.02) and an almost 3-fold increased odds of low-contrast VA worsening (adjusted OR 2.93, 95% CI 1.40-6.13; p = 0.04).ConclusionsLower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS. Accordingly, SD-OCT at a single time point may help guide therapeutic decision-making among individual PwMS.Classification of EvidenceThis study provides Class I evidence that lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS.
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U2 - 10.1212/WNL.0000000000011788
DO - 10.1212/WNL.0000000000011788
M3 - Article
C2 - 33653904
AN - SCOPUS:85106539218
SN - 0028-3878
VL - 96
SP - E2058-E2069
JO - Neurology
JF - Neurology
IS - 16
ER -