@article{ee6e4e26b8eb43758232a66c1345151d,
title = "Evidence of subclinical quantitative retinal layer abnormalities in AQP4-IgG seropositive NMOSD",
abstract = "Background: Prior studies have suggested that subclinical retinal abnormalities may be present in aquaporin-4 immunoglobulin G (AQP4-IgG) seropositive neuromyelitis optica spectrum disorder (NMOSD), in the absence of a clinical history of optic neuritis (ON). Objective: Our aim was to compare retinal layer thicknesses at the fovea and surrounding macula between AQP4-IgG+ NMOSD eyes without a history of ON (AQP4-nonON) and healthy controls (HC). Methods: In this single-center cross-sectional study, 83 AQP4-nonON and 154 HC eyes were studied with spectral-domain optical coherence tomography (OCT). Results: Total foveal thickness did not differ between AQP4-nonON and HC eyes. AQP4-nonON eyes exhibited lower outer nuclear layer (ONL) and inner photoreceptor segment (IS) thickness at the fovea (ONL: −4.01 ± 2.03 μm, p = 0.049; IS: −0.32 ± 0.14 μm, p = 0.029) and surrounding macula (ONL: −1.98 ± 0.95 μm, p = 0.037; IS: −0.16 ± 0.07 μm, p = 0.023), compared to HC. Macular retinal nerve fiber layer (RNFL: −1.34 ± 0.51 μm, p = 0.009) and ganglion cell + inner plexiform layer (GCIPL: −2.44 ± 0.93 μm, p = 0.009) thicknesses were also lower in AQP4-nonON compared to HC eyes. Results were similar in sensitivity analyses restricted to AQP4-IgG+ patients who had never experienced ON in either eye. Conclusions: AQP4-nonON eyes exhibit evidence of subclinical retinal ganglion cell neuronal and axonal loss, as well as structural evidence of photoreceptor layer involvement. These findings support that subclinical anterior visual pathway involvement may occur in AQP4-IgG+ NMOSD.",
keywords = "Neuromyelitis optica, aquaporin-4, fovea, optical coherence tomography, retina",
author = "Filippatou, {Angeliki G.} and Vasileiou, {Eleni S.} and Yufan He and Fitzgerald, {Kathryn C.} and Grigorios Kalaitzidis and Jeffrey Lambe and Mealy, {Maureen A.} and Michael Levy and Yihao Liu and Prince, {Jerry L.} and Mowry, {Ellen M.} and Shiv Saidha and Calabresi, {Peter A.} and Sotirchos, {Elias S.}",
note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MAM is an employee of Viela Bio. ML has received research support from National Institutes of Health, Maryland Technology Development Corporation, Sanofi, Genzyme, Alexion, Alnylam, Shire, Acorda, and Apopharma. He has also received personal compensation for consultation with Alexion, Acorda, and Genzyme and he serves on the scientific advisory boards for Alexion, Acorda, and Quest Diagnostics. JLP is a founder of Sonovex, Inc. and serves on its Board of Directors. He has received consulting fees from JuneBrain LLC and is PI on research grants to Johns Hopkins from Biogen. EMM has grants from Biogen and Genzyme, is site PI for studies sponsored by Biogen, has received free medication for a clinical trial from Teva, and receives royalties for editorial duties from UpToDate. SS has received consulting fees from Medical Logix for the development of CME programs in neurology and has served on scientific advisory boards for Biogen, Genzyme, Genentech Corporation, EMD Serono, and Celgene. He is the PI of investigator-initiated studies funded by Genentech Corporation and Biogen, and received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC, a retinal imaging device developer. He is also the site investigator of a trial sponsored by MedDay Pharmaceuticals. PAC has received consulting fees from Disarm Therapeutics and Biogen and is PI on grants to JHU from Biogen and Annexon. ESS has received speaker honoraria from Viela Bio and has served on scientific advisory boards for Viela Bio and Genentech. AGF, ESV, YH, GK, KCF, JL, and YL report no disclosures. 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 the Caring Friends NMO Research fund, National MS Society (FP-1607-24999 to ESS, RG-1606-08768 to SS; TA-1805-31136 to KCF), NIH/NINDS (R01NS082347 to PAC; K23NS117883 to ESS), NIH/NIMH (K01MH121582 to KCF). ",
year = "2020",
doi = "10.1177/1352458520977771",
language = "English (US)",
journal = "Multiple Sclerosis",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
}