Impact of treatment over thickness of the retinal layers in patients with demyelinating diseases
Enrique Gomez Figueroa1, Roberto Rodríguez-Rivas2, Veronica Rivas2, Teresita Corona Vazquez3, Jose de Jesus Flores2
1Neurology Department, Hospital Civil de Guadalajara. «Fray Antonio Alcalde»., 2Clínica de Enfermedades Desmielinizantes, Instituto Nacional de Neurología y Neurocirugía. Manuel Velazco Suárez., 3Jefatura de estudios de posgrado, Universidad Nacional Autónoma de México
Objective:

To compare the thickness and loss of retinal layers between therapeutic groups of patients with demyelinating diseases presenting with optic neuritis.

Background:

Optical Coherence Tomography (OCT) is postulated as a possible tool for the follow-up of patients with demyelinating diseases. The effects of drugs such as Natalizumab on the loss of thickness in the ganglion cell layer (GCC) have been described in patients with multiple sclerosis, however, information on other treatments in this area is scarce.

Design/Methods:

We collected patient data from the Demyelinating Diseases Clinic of the INNN between 2010 and 2022 with OCT. The Kruskall Wallis test and Tukey's post-hoc analysis with Bonferroni correction were used to identify differences between the groups. With multivariate regression analysis we determined the effect of confounding variables on the thickness of the layers of interest.

Results:

We found 77% women, with a mean age of 37.5 years (range 21-66). Mean evolution time 4.9 years (SD 3.74). Mean EDSS 1.25 (SD +/- 1.85). Ocrelizumab showed greater thickness in the GCC of the RE (ΔM: 19.28 CI [3.40-35.15] p=0.013) and LE (ΔM: 24.50 CI [5.52-43.57] p=0.008) as well as a lower percentage of lymph node volume lost in the RE (4.8 [ SD +/- 4.1 p=0.017]) and LE (4.6 [SD +/- 4.10 p=0.012]). Natalizumab had the highest thickness in the ST-OD quadrant (ΔM: 54.22 CI [2.38-85.82] p=0.008). With multivariate analysis, gender (p=1.0), affected eye (p=0.607), evolution time (p=0.35), EDSS (0.14) and final diagnosis (p =0.55) did not show significant interactions with the effect of the drug on the thickness of the layers.

Conclusions:
This study suggests that different therapies such as Ocrelizumab and Natalizumab have a greater positive impact compared to other therapies on the thickness of the ganglion cell layer, macular areas and retinal fibers.
10.1212/WNL.0000000000203406