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 Calabresi, Scott Newsome

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalMultiple Sclerosis Journal
DOIs
StateAccepted/In press - Nov 1 2017

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Odds Ratio
Optical Coherence Tomography
Matrix Metalloproteinases
Epiretinal Membrane
Ophthalmology
African Americans
Referral and Consultation
Cross-Sectional Studies
Logistic Models
Demography
Pathology

Keywords

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

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Al-Louzi, O., Sotirchos, E. S., Vidal-Jordana, A., Beh, S. C., Button, J., Ying, H. S., ... Newsome, S. (Accepted/In press). Characteristics of morphologic macular abnormalities in neuroimmunology practice. Multiple Sclerosis Journal. https://doi.org/10.1177/1352458517741206

Characteristics of morphologic macular abnormalities in neuroimmunology practice. / Al-Louzi, Omar; Sotirchos, Elias S.; Vidal-Jordana, Angela; Beh, Shin C.; Button, Julia; Ying, Howard S.; Balcer, Laura J.; Frohman, Elliot M.; Saidha, Shiv; Calabresi, Peter; Newsome, Scott.

In: Multiple Sclerosis Journal, 01.11.2017.

Research output: Contribution to journalArticle

Al-Louzi, Omar ; Sotirchos, Elias S. ; Vidal-Jordana, Angela ; Beh, Shin C. ; Button, Julia ; Ying, Howard S. ; Balcer, Laura J. ; Frohman, Elliot M. ; Saidha, Shiv ; Calabresi, Peter ; Newsome, Scott. / Characteristics of morphologic macular abnormalities in neuroimmunology practice. In: Multiple Sclerosis Journal. 2017.
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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.",
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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

AU - Newsome, Scott

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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 - drusen

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KW - Multiple sclerosis

KW - neuromyelitis optica

KW - optical coherence tomography

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