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Abstract Details

Optical coherence tomography demonstrates occult optic neuropathy in neurosarcoidosis
Autoimmune Neurology
P15 - Poster Session 15 (12:00 PM-1:00 PM)
15-002
To evaluate whether retinal layer thicknesses differ in a large cohort of patients with neurosarcoidosis (NS) as compared to healthy controls (HCs), and examine retinal layer thickness abnormalities according to NS phenotypes and global disability levels.
Clinically-evident optic neuropathy is a known manifestation in NS and can be characterized using optical coherence tomography (OCT). However, the presence and clinical significance of occult optic neuropathy in patients with NS – a disorder with diverse clinical phenotypes - remains largely unexplored. 
In this cross-sectional study, 88 patients with NS (176 eyes; 38 with history of clinically-evident optic neuropathy [NS-ON] and 144 without [NS-NON]) and 83 age-,race- and sex-matched HCs underwent spectral-domain OCT assessment. Patients with a history of other ophthalmological disorders, including intraocular sarcoidosis, were excluded. Statistical analyses were performed using mixed-effects linear regression models, accounting for within-subject inter-eye correlations.
Mean ganglion cell + inner plexiform layer (GCIPL) thickness was reduced in both NS-ON eyes (64.6±11.4µm) and NS-NON eyes (73.2±6.5µm) as compared to HC eyes (75.3±8.8µm; p<0.001 and p=0.004, respectively). Mean peripapillary retinal nerve fiber layer (pRNFL) thickness was lower in NS-ON eyes (77.3 µm±15.8µm) versus NS-NON eyes (92.9±11.7µm; p<0.001) and HC eyes (93.3±9.6µm; p<0.001). Examining NS phenotypes, GCIPL thickness was reduced in patients with involvement of any cranial nerve (even after excluding NS-ON eyes) as compared to patients without cranial nerve involvement (p=0.02).Finally, lower GCIPL thickness was associated with higher levels of global disability as measured by the modified Rankin Score (p=0.02).
Patients with NS exhibit lower GCIPL and pRNFL thicknesses as compared to HCs. Furthermore, GCIPL thickness – a sensitive marker of retinal neuro-axonal loss – is reduced even in NS eyes without a history of clinically-evident optic neuropathy. Our findings suggest that occult optic neuropathy occurs in NS and may act as a marker of widespread central nervous system degeneration.
Authors/Disclosures
Ruth Andrea Salazar Camelo, MD (Johns Hopkins School of Medicine)
PRESENTER 		Dr. Salazar Camelo has nothing to disclose.
Olwen Murphy, MD (Johns Hopkins Hospital) Dr. Murphy has nothing to disclose.
Jeffrey Lambe, MD Dr. Lambe has nothing to disclose.
Angeliki Filippatou, MD (Johns Hopkins University School of Medicine) Dr. Filippatou has nothing to disclose.
Peter A. Calabresi, MD, FÂ鶹´«Ã½Ó³»­ (Johns Hopkins University) Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.
Shiv Saidha, MD (Johns Hopkins) Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Setpoint Medical. Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ReWind Therapeutics. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Clene Pharmaceuticals. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal ETC. Dr. Saidha has stock in June Brain. Dr. Saidha has stock in Lapix Therapeutics. The institution of Dr. Saidha has received research support from Biogen. The institution of Dr. Saidha has received research support from Genentech. The institution of Dr. Saidha has received research support from Novartis. The institution of Dr. Saidha has received research support from Lapix Therapeutics. The institution of Dr. Saidha has received research support from Novartis.
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology) The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .