Retinal measurements predict 10-year disability in multiple sclerosis

Alissa Rothman, Olwen C. Murphy, Kathryn Fitzgerald, Julia Button, Eliza Gordon-Lipkin, John N. Ratchford, Scott Newsome, Ellen Mahar Mowry, Elias S. Sotirchos, Stephanie B. Syc-Mazurek, James Nguyen, Natalia Gonzalez Caldito, Laura J. Balcer, Elliot M. Frohman, Teresa C. Frohman, Daniel S. Reich, Ciprian M Crainiceanu, Shiv Saidha, Peter Calabresi

Research output: Contribution to journalArticle

Abstract

Objective: Optical coherence tomography (OCT)-derived measures of the retina correlate with disability and cortical gray matter atrophy in multiple sclerosis (MS); however, whether such measures predict long-term disability is unknown. We evaluated whether a single OCT and visual function assessment predict the disability status 10 years later. Methods: Between 2006 and 2008, 172 people with MS underwent Stratus time domain-OCT imaging [160 with measurement of total macular volume (TMV)] and high and low-contrast letter acuity (LCLA) testing (n = 150; 87%). All participants had Expanded Disability Status Scale (EDSS) assessments at baseline and at 10-year follow-up. We applied generalized linear regression models to assess associations between baseline TMV, peripapillary retinal nerve fiber layer (pRNFL) thickness, and LCLA with 10-year EDSS scores (linear) and with clinically significant EDSS worsening (binary), adjusting for age, sex, optic neuritis history, and baseline disability status. Results: In multivariable models, lower baseline TMV was associated with higher 10-year EDSS scores (mean increase in EDSS of 0.75 per 1 mm3 loss in TMV (mean difference = 0.75; 95% CI: 0.11–1.39; P = 0.02). In analyses using tertiles, individuals in the lowest tertile of baseline TMV had an average 0.86 higher EDSS scores at 10 years (mean difference = 0.86; 95% CI: 0.23–1.48) and had over 3.5-fold increased odds of clinically significant EDSS worsening relative to those in the highest tertile of baseline TMV (OR: 3.58; 95% CI: 1.30–9.82; Ptrend= 0.008). pRNFL and LCLA predicted the 10-year EDSS scores only in univariate models. Interpretation: Lower baseline TMV measured by OCT significantly predicts higher disability at 10 years, even after accounting for baseline disability status.

Original languageEnglish (US)
JournalAnnals of Clinical and Translational Neurology
DOIs
StateAccepted/In press - Jan 1 2019

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Optical Coherence Tomography
Multiple Sclerosis
Nerve Fibers
Linear Models
Optic Neuritis
Atrophy
Retina

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Retinal measurements predict 10-year disability in multiple sclerosis. / Rothman, Alissa; Murphy, Olwen C.; Fitzgerald, Kathryn; Button, Julia; Gordon-Lipkin, Eliza; Ratchford, John N.; Newsome, Scott; Mowry, Ellen Mahar; Sotirchos, Elias S.; Syc-Mazurek, Stephanie B.; Nguyen, James; Caldito, Natalia Gonzalez; Balcer, Laura J.; Frohman, Elliot M.; Frohman, Teresa C.; Reich, Daniel S.; Crainiceanu, Ciprian M; Saidha, Shiv; Calabresi, Peter.

In: Annals of Clinical and Translational Neurology, 01.01.2019.

Research output: Contribution to journalArticle

Rothman, A, Murphy, OC, Fitzgerald, K, Button, J, Gordon-Lipkin, E, Ratchford, JN, Newsome, S, Mowry, EM, Sotirchos, ES, Syc-Mazurek, SB, Nguyen, J, Caldito, NG, Balcer, LJ, Frohman, EM, Frohman, TC, Reich, DS, Crainiceanu, CM, Saidha, S & Calabresi, P 2019, 'Retinal measurements predict 10-year disability in multiple sclerosis', Annals of Clinical and Translational Neurology. https://doi.org/10.1002/acn3.674
Rothman, Alissa ; Murphy, Olwen C. ; Fitzgerald, Kathryn ; Button, Julia ; Gordon-Lipkin, Eliza ; Ratchford, John N. ; Newsome, Scott ; Mowry, Ellen Mahar ; Sotirchos, Elias S. ; Syc-Mazurek, Stephanie B. ; Nguyen, James ; Caldito, Natalia Gonzalez ; Balcer, Laura J. ; Frohman, Elliot M. ; Frohman, Teresa C. ; Reich, Daniel S. ; Crainiceanu, Ciprian M ; Saidha, Shiv ; Calabresi, Peter. / Retinal measurements predict 10-year disability in multiple sclerosis. In: Annals of Clinical and Translational Neurology. 2019.
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title = "Retinal measurements predict 10-year disability in multiple sclerosis",
abstract = "Objective: Optical coherence tomography (OCT)-derived measures of the retina correlate with disability and cortical gray matter atrophy in multiple sclerosis (MS); however, whether such measures predict long-term disability is unknown. We evaluated whether a single OCT and visual function assessment predict the disability status 10 years later. Methods: Between 2006 and 2008, 172 people with MS underwent Stratus time domain-OCT imaging [160 with measurement of total macular volume (TMV)] and high and low-contrast letter acuity (LCLA) testing (n = 150; 87{\%}). All participants had Expanded Disability Status Scale (EDSS) assessments at baseline and at 10-year follow-up. We applied generalized linear regression models to assess associations between baseline TMV, peripapillary retinal nerve fiber layer (pRNFL) thickness, and LCLA with 10-year EDSS scores (linear) and with clinically significant EDSS worsening (binary), adjusting for age, sex, optic neuritis history, and baseline disability status. Results: In multivariable models, lower baseline TMV was associated with higher 10-year EDSS scores (mean increase in EDSS of 0.75 per 1 mm3 loss in TMV (mean difference = 0.75; 95{\%} CI: 0.11–1.39; P = 0.02). In analyses using tertiles, individuals in the lowest tertile of baseline TMV had an average 0.86 higher EDSS scores at 10 years (mean difference = 0.86; 95{\%} CI: 0.23–1.48) and had over 3.5-fold increased odds of clinically significant EDSS worsening relative to those in the highest tertile of baseline TMV (OR: 3.58; 95{\%} CI: 1.30–9.82; Ptrend= 0.008). pRNFL and LCLA predicted the 10-year EDSS scores only in univariate models. Interpretation: Lower baseline TMV measured by OCT significantly predicts higher disability at 10 years, even after accounting for baseline disability status.",
author = "Alissa Rothman and Murphy, {Olwen C.} and Kathryn Fitzgerald and Julia Button and Eliza Gordon-Lipkin and Ratchford, {John N.} and Scott Newsome and Mowry, {Ellen Mahar} and Sotirchos, {Elias S.} and Syc-Mazurek, {Stephanie B.} and James Nguyen and Caldito, {Natalia Gonzalez} and Balcer, {Laura J.} and Frohman, {Elliot M.} and Frohman, {Teresa C.} and Reich, {Daniel S.} and Crainiceanu, {Ciprian M} and Shiv Saidha and Peter Calabresi",
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T1 - Retinal measurements predict 10-year disability in multiple sclerosis

AU - Rothman, Alissa

AU - Murphy, Olwen C.

AU - Fitzgerald, Kathryn

AU - Button, Julia

AU - Gordon-Lipkin, Eliza

AU - Ratchford, John N.

AU - Newsome, Scott

AU - Mowry, Ellen Mahar

AU - Sotirchos, Elias S.

AU - Syc-Mazurek, Stephanie B.

AU - Nguyen, James

AU - Caldito, Natalia Gonzalez

AU - Balcer, Laura J.

AU - Frohman, Elliot M.

AU - Frohman, Teresa C.

AU - Reich, Daniel S.

AU - Crainiceanu, Ciprian M

AU - Saidha, Shiv

AU - Calabresi, Peter

PY - 2019/1/1

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N2 - Objective: Optical coherence tomography (OCT)-derived measures of the retina correlate with disability and cortical gray matter atrophy in multiple sclerosis (MS); however, whether such measures predict long-term disability is unknown. We evaluated whether a single OCT and visual function assessment predict the disability status 10 years later. Methods: Between 2006 and 2008, 172 people with MS underwent Stratus time domain-OCT imaging [160 with measurement of total macular volume (TMV)] and high and low-contrast letter acuity (LCLA) testing (n = 150; 87%). All participants had Expanded Disability Status Scale (EDSS) assessments at baseline and at 10-year follow-up. We applied generalized linear regression models to assess associations between baseline TMV, peripapillary retinal nerve fiber layer (pRNFL) thickness, and LCLA with 10-year EDSS scores (linear) and with clinically significant EDSS worsening (binary), adjusting for age, sex, optic neuritis history, and baseline disability status. Results: In multivariable models, lower baseline TMV was associated with higher 10-year EDSS scores (mean increase in EDSS of 0.75 per 1 mm3 loss in TMV (mean difference = 0.75; 95% CI: 0.11–1.39; P = 0.02). In analyses using tertiles, individuals in the lowest tertile of baseline TMV had an average 0.86 higher EDSS scores at 10 years (mean difference = 0.86; 95% CI: 0.23–1.48) and had over 3.5-fold increased odds of clinically significant EDSS worsening relative to those in the highest tertile of baseline TMV (OR: 3.58; 95% CI: 1.30–9.82; Ptrend= 0.008). pRNFL and LCLA predicted the 10-year EDSS scores only in univariate models. Interpretation: Lower baseline TMV measured by OCT significantly predicts higher disability at 10 years, even after accounting for baseline disability status.

AB - Objective: Optical coherence tomography (OCT)-derived measures of the retina correlate with disability and cortical gray matter atrophy in multiple sclerosis (MS); however, whether such measures predict long-term disability is unknown. We evaluated whether a single OCT and visual function assessment predict the disability status 10 years later. Methods: Between 2006 and 2008, 172 people with MS underwent Stratus time domain-OCT imaging [160 with measurement of total macular volume (TMV)] and high and low-contrast letter acuity (LCLA) testing (n = 150; 87%). All participants had Expanded Disability Status Scale (EDSS) assessments at baseline and at 10-year follow-up. We applied generalized linear regression models to assess associations between baseline TMV, peripapillary retinal nerve fiber layer (pRNFL) thickness, and LCLA with 10-year EDSS scores (linear) and with clinically significant EDSS worsening (binary), adjusting for age, sex, optic neuritis history, and baseline disability status. Results: In multivariable models, lower baseline TMV was associated with higher 10-year EDSS scores (mean increase in EDSS of 0.75 per 1 mm3 loss in TMV (mean difference = 0.75; 95% CI: 0.11–1.39; P = 0.02). In analyses using tertiles, individuals in the lowest tertile of baseline TMV had an average 0.86 higher EDSS scores at 10 years (mean difference = 0.86; 95% CI: 0.23–1.48) and had over 3.5-fold increased odds of clinically significant EDSS worsening relative to those in the highest tertile of baseline TMV (OR: 3.58; 95% CI: 1.30–9.82; Ptrend= 0.008). pRNFL and LCLA predicted the 10-year EDSS scores only in univariate models. Interpretation: Lower baseline TMV measured by OCT significantly predicts higher disability at 10 years, even after accounting for baseline disability status.

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