Relation of Optical Coherence Tomography (OCT) Measures to Volumetric MRI in Pediatric-Onset Multiple Sclerosis (POMS)
Anna Sosa1, Ruben Jauregui1, Ugo Nwigwe1, Kimberly O'Neill1, Rachel Kenney1, Thibo Billiet2, Lauren Krupp1, Steven Galetta1, Laura Balcer1, Scott Grossman1
1Neurology, NYU Grossman School of Medicine, 2icometrix
Objective:
To examine the relation of optical coherence tomography (OCT) measures to MRI brain volumetrics in patients with pediatric-onset multiple sclerosis (POMS).
Background:
Whole and regional brain tissue volumes and OCT measures have emerged as important structural markers that reflect impairment and disability in MS. How these structural measures of the eye and brain relate to each other is unclear in POMS.
Design/Methods:
This was a retrospective cross-sectional study of OCT and MRI measures in a POMS cohort at a single pediatric MS center. MRI measures of brain volume that were performed as part of clinical care include overall lesion and black hole volumes and volume percentiles (based on age- and sex-related norms) for whole brain (WB), cortical grey matter (CGM), grey matter (GM), hippocampus, and thalamus. Peripapillary retinal nerve fiber layer (RNFL) thickness and macular volumes were recorded from OCT scans obtained during neuro-ophthalmic consultation.
Results:
Among 72 patients (144 eyes), median age at the time of the volumetric MRI scan was 18.8 (range 10.6-27.7) years, with a median disease duration of 3.7 (0.13-16.7) years. Lower (worse) RNFL thicknesses (median 93.1 microns [53-134]) were associated with reduced volumes of WB (p<0.001), CGM (p<0.001), GM (p<0.001), and thalamus (p=0.03, generalized estimating equation [GEE] models). RNFL thinning was also associated with greater lesion (p=0.009) and black hole volumes (p=0.003). Macular volumes were reduced for eyes associated with lower WB (p=0.001) and hippocampal volume (p=0.006). On average, 5 mm reductions in RNFL thickness were associated with decreases in whole brain volume by 12 percentile points and with increases in black hole volume by 12 mm3.
Conclusions:
Peripapillary RNFL thinning in POMS may reflect loss in overall brain volume and greater lesion and black hole burden on volumetric MRI. As such, OCT measures represent useful markers of disease status in addition to demonstrating optic nerve involvement in MS.
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