Characteristics of morphologic macular abnormalities in neuroimmunology practice

Omar Al-Louzi; Elias S. Sotirchos; Angela Vidal-Jordana; Shin C. Beh; Julia Button; Howard S. Ying; Laura J. Balcer; Elliot M. Frohman; Shiv Saidha; Peter A. Calabresi; Scott D. Newsome

doi:10.1177/1352458517741206

Characteristics of morphologic macular abnormalities in neuroimmunology practice

Omar Al-Louzi, Elias S. Sotirchos, Angela Vidal-Jordana, Shin C. Beh, Julia Button, Howard S. Ying, Laura J. Balcer, Elliot M. Frohman, Shiv Saidha, Peter A. Calabresi, Scott D. Newsome

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. Objective: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. Methods: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. Results: MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10 ^–5 ) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10 ^–5 and 7 × 10 ^–3 , respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10 ^–5 ). Conclusion: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.

Original language	English (US)
Pages (from-to)	361-371
Number of pages	11
Journal	Multiple Sclerosis Journal
Volume	25
Issue number	3
DOIs	https://doi.org/10.1177/1352458517741206
State	Published - Mar 1 2019

Keywords

Multiple sclerosis
drusen
epiretinal membrane
microcystoid macular pathology
neuromyelitis optica
optical coherence tomography

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1177/1352458517741206

Cite this

@article{1f576d5371974d76bc163940181aeb62,

title = "Characteristics of morphologic macular abnormalities in neuroimmunology practice",

abstract = " Background: Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. Objective: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. Methods: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. Results: MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10 –5 ) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10 –5 and 7 × 10 –3 , respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10 –5 ). Conclusion: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.",

keywords = "Multiple sclerosis, drusen, epiretinal membrane, microcystoid macular pathology, neuromyelitis optica, optical coherence tomography",

author = "Omar Al-Louzi and Sotirchos, {Elias S.} and Angela Vidal-Jordana and Beh, {Shin C.} and Julia Button and Ying, {Howard S.} and Balcer, {Laura J.} and Frohman, {Elliot M.} and Shiv Saidha and Calabresi, {Peter A.} and Newsome, {Scott D.}",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by a Race to Erase MS grant to S.S. and National Institutes of Health grant 5R01NS082347 to P.A.C. Publisher Copyright: {\textcopyright} The Author(s), 2017.",

year = "2019",

month = mar,

day = "1",

doi = "10.1177/1352458517741206",

language = "English (US)",

volume = "25",

pages = "361--371",

journal = "Multiple Sclerosis",

issn = "1352-4585",

publisher = "SAGE Publications Ltd",

number = "3",

}

TY - JOUR

T1 - Characteristics of morphologic macular abnormalities in neuroimmunology practice

AU - Al-Louzi, Omar

AU - Sotirchos, Elias S.

AU - Vidal-Jordana, Angela

AU - Beh, Shin C.

AU - Button, Julia

AU - Ying, Howard S.

AU - Balcer, Laura J.

AU - Frohman, Elliot M.

AU - Saidha, Shiv

AU - Calabresi, Peter A.

AU - Newsome, Scott D.

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by a Race to Erase MS grant to S.S. and National Institutes of Health grant 5R01NS082347 to P.A.C. Publisher Copyright: © The Author(s), 2017.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. Objective: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. Methods: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. Results: MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10 –5 ) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10 –5 and 7 × 10 –3 , respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10 –5 ). Conclusion: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.

AB - Background: Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. Objective: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. Methods: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. Results: MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10 –5 ) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10 –5 and 7 × 10 –3 , respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10 –5 ). Conclusion: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.

KW - Multiple sclerosis

KW - drusen

KW - epiretinal membrane

KW - microcystoid macular pathology

KW - neuromyelitis optica

KW - optical coherence tomography

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SN - 1352-4585

VL - 25

SP - 361

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JO - Multiple Sclerosis

JF - Multiple Sclerosis

IS - 3

ER -

Characteristics of morphologic macular abnormalities in neuroimmunology practice

Abstract

Keywords

ASJC Scopus subject areas

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