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Abstract Details

Associations Between Vascular Comorbidity, Visual Acuity and Optical Coherence Tomography in Secondary Progressive Multiple Sclerosis
Multiple Sclerosis
P16 - Poster Session 16 (5:30 PM-6:30 PM)
9-015

To determine the effect of VC on cross-sectional and longitudinal retinal nerve fiber (RNFL) and ganglion cell plus inner plexiform layers (GCIPL) thickness and high contrast visual acuity in people with secondary progressive multiple sclerosis (pwSPMS) enrolled in a clinical trial.

Vascular comorbidity (VC), defined as having hypertension, dyslipidemia, type-2 diabetes, obesity, peripheral or cardiovascular disease, is highly prevalent and associated with poor health outcomes. VC in people with multiple sclerosis (pwMS) is likewise associated with greater visual disability. However, there is limited longitudinal data investigating the relationship between VC and visual outcomes from clinical trials in pwMS.
Data was extracted from a 2-year, randomized controlled trial (n=51) testing the supplement lipoic acid in pwSPMS who underwent annual SD-OCT and visual acuity testing. Post-hoc analysis using mixed-effects linear regression compared baseline and annualized RNFL and GCIPL atrophy rates and visual acuity between participants with and without ≥1 VC, accounting for age, sex, MS disease duration, history of optic neuritis, baseline RNFL/GCIPL thickness, and study arm.
Forty-seven subjects had sufficient data for analysis. Subject without (n=19) and with ≥1 VC (n=28) were similar in age, sex, MS disease duration, and baseline RNFL and GCIPL thickness. Those with ≥1 VC had significantly worse baseline visual acuity than those without VC (0.13 vs 0 logMAR, p=0.041). Subjects with VC demonstrated 0.7 µm/year decrease in RNFL thickness compared to 0.09 µm/year increase in those without VC (p=0.068). Annualized GCIPL atrophy (-0.2 vs. -0.1 µm/year, p=0.69) and loss of visual acuity (-0.01 vs. 0.04 logMAR/year; p=0.12) were comparable between subjects with and without VC, respectively.
In a cohort of pwSPMS, VC had a significant effect on baseline visual acuity, but not on baseline and longitudinal atrophy in RNFL/GCIPL thickness. VC should be considered as a modifier in clinical trials for pwMS using visual outcomes.
Authors/Disclosures
Kathleen Shangraw (OHSU)
PRESENTER 		No disclosure on file
No disclosure on file
Andrea Hildebrand (VA Portland Health Care System) The institution of Ms. Hildebrand has received research support from National MS Society.
Rebecca Spain, MD, MSPH, FÂ鶹´«Ã½Ó³»­ Dr. Spain has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for United States Department of Justice. The institution of Dr. Spain has received research support from Department of Veterans Affairs. The institution of Dr. Spain has received research support from National Multiple Sclerosis Society.