NeuroCure Clinical Research Center Neuromyelitis optica spectrum disorders and multiple sclerosis: from clinical differences in the afferent visual system to pathology Alexander U. Brandt IMSVISUAL Symposium ACTRIMS 2017 @ Orlando, FL
Neuromyelitis optica spectrum disorders and multiple sclerosis: from clinical differences in the afferent visual system to pathology
Nov 11, 2022
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afferent visual system to pathology Alexander U. Brandt
IMSVISUAL Symposium ACTRIMS 2017 @ Orlando, FL
Neuromyelitis Optica Spectrum Disorders
• Rare disease defined by optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM), sometimes other CNS symptoms.
• Antibody against astrocytic AQP4 channels detected in the majority of patients by Lennon et al. Lancet 2004
Schneider et al. PONE 2013
NMOSD related optic neuritis leads to severe loss of visual function
Schmidt & Zimmermann et al. MSARD 2017
NON/UON/BON NMO: 8/10/13 MS: 4/16/11
NMOSD is a heterogeneous disease
AQP4-ab-pos MOG-ab-pos
Pache & Zimmermann et al. J Neuroinfl 2016
Occult Damage in NMOSD?
MS Control
P < 0.001
P < 0.001
Ventura et al. Neurology N2 2016 Jeong et al. J Neurol 2016
Antibody status?
Other attacks?
Chiasmal crossover?
Foveal thickness reduction in LETM-only papients
Oertel & Kuchling et al. Neurology N2 2017
NMOSD rat-model shows human IgG-dependent retinal AQP4 loss
Felix et al. J Neuroinfl 2016
Conclusion
AQP4-ab seropositive NMOSD patients show microstructural damage in the visual system independent of optic neuritis • Foveal thickness reduction (without apparent retinal axonal damage) • Optic radiation affection
Questions • Functional relevance? • Other brain areas? • Diagnostic implications? • Longitudinal/therapeutic implications?
Follow-Up 23 NMOSD AQP4-Pos
began
(+/- before follow-up also)
1 eye with ON < 3 months before first visit
11 eyes with all ONs ≥3 months before first
visit
33 eyes comprising ‘NMOSD NON’ group
Oertel et al. (in preparation)
Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica Parallel Study on MRI in Neuromyelitis Optica
Berlin Strassbourg Lyon
Odense
Istanbul
Data contribution of 350 NMOSD patients and 100 healthy controls has been pledged from 20+ centers. CROCTINO is including, PAMRINO about to start!
San Francisco
Charité - Neuroimmunology Felix Schmidt
Charité – Department of Neurology Klemens Ruprecht
[email protected]
IMSVISUAL Symposium ACTRIMS 2017 @ Orlando, FL
Neuromyelitis Optica Spectrum Disorders
• Rare disease defined by optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM), sometimes other CNS symptoms.
• Antibody against astrocytic AQP4 channels detected in the majority of patients by Lennon et al. Lancet 2004
Schneider et al. PONE 2013
NMOSD related optic neuritis leads to severe loss of visual function
Schmidt & Zimmermann et al. MSARD 2017
NON/UON/BON NMO: 8/10/13 MS: 4/16/11
NMOSD is a heterogeneous disease
AQP4-ab-pos MOG-ab-pos
Pache & Zimmermann et al. J Neuroinfl 2016
Occult Damage in NMOSD?
MS Control
P < 0.001
P < 0.001
Ventura et al. Neurology N2 2016 Jeong et al. J Neurol 2016
Antibody status?
Other attacks?
Chiasmal crossover?
Foveal thickness reduction in LETM-only papients
Oertel & Kuchling et al. Neurology N2 2017
NMOSD rat-model shows human IgG-dependent retinal AQP4 loss
Felix et al. J Neuroinfl 2016
Conclusion
AQP4-ab seropositive NMOSD patients show microstructural damage in the visual system independent of optic neuritis • Foveal thickness reduction (without apparent retinal axonal damage) • Optic radiation affection
Questions • Functional relevance? • Other brain areas? • Diagnostic implications? • Longitudinal/therapeutic implications?
Follow-Up 23 NMOSD AQP4-Pos
began
(+/- before follow-up also)
1 eye with ON < 3 months before first visit
11 eyes with all ONs ≥3 months before first
visit
33 eyes comprising ‘NMOSD NON’ group
Oertel et al. (in preparation)
Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica Parallel Study on MRI in Neuromyelitis Optica
Berlin Strassbourg Lyon
Odense
Istanbul
Data contribution of 350 NMOSD patients and 100 healthy controls has been pledged from 20+ centers. CROCTINO is including, PAMRINO about to start!
San Francisco
Charité - Neuroimmunology Felix Schmidt
Charité – Department of Neurology Klemens Ruprecht
[email protected]
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