Omar Al-Louzi1, Elias S Sotirchos1, Angela Vidal-Jordana2, Shin C Beh3, Julia Button1, Howard S Ying4, Laura J Balcer5, Elliot M Frohman3, Shiv Saidha1, Peter A Calabresi1, Scott D Newsome1. 1. Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA. 2. Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 3. Department of Neurology and Ophthalmology, University of Texas Southwestern, Dallas, TX, USA. 4. Department of Ophthalmology, Boston Medical Center, Boston, MA, USA. 5. Departments of Neurology, Population Health and Ophthalmology, New York University School of Medicine, New York, NY, USA.
Abstract
BACKGROUND: Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. OBJECTIVE: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. METHODS: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. RESULTS: MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10-5) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10-5 and 7 × 10-3, respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10-5). CONCLUSION: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.
BACKGROUND:Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. OBJECTIVE: To describe the characteristics of MMAs in a neuroimmunology-based academic practice. METHODS: Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. RESULTS:MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10-5) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10-5 and 7 × 10-3, respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10-5). CONCLUSION: Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.
Authors: Dorlan J Kimbrough; Elias S Sotirchos; James A Wilson; Omar Al-Louzi; Amy Conger; Darrel Conger; Teresa C Frohman; Shiv Saidha; Ari J Green; Elliot M Frohman; Laura J Balcer; Peter A Calabresi Journal: Ann Neurol Date: 2015-01-13 Impact factor: 10.422
Authors: Daniel J McCarty; Bickol N Mukesh; Vatsal Chikani; Jie J Wang; Paul Mitchell; Hugh R Taylor; Catherine A McCarty Journal: Am J Ophthalmol Date: 2005-08 Impact factor: 5.258
Authors: Helena Buch; Niels V Nielsen; Troels Vinding; Gorm B Jensen; Jan U Prause; Morten la Cour Journal: Ophthalmology Date: 2005-05 Impact factor: 12.079
Authors: Cynthia A Carvalho-Recchia; Lawrence A Yannuzzi; Silvana Negrão; Richard F Spaide; K Bailey Freund; Hanna Rodriguez-Coleman; Marcio Lenharo; Tomohiro Iida Journal: Ophthalmology Date: 2002-10 Impact factor: 12.079
Authors: Elias S Sotirchos; Shiv Saidha; Gita Byraiah; Maureen A Mealy; Mohamed A Ibrahim; Yasir Jamal Sepah; Scott D Newsome; John N Ratchford; Elliot M Frohman; Laura J Balcer; Ciprian M Crainiceanu; Quan Dong Nguyen; Michael Levy; Peter A Calabresi Journal: Neurology Date: 2013-03-20 Impact factor: 9.910
Authors: Prejaas Tewarie; Lisanne Balk; Fiona Costello; Ari Green; Roland Martin; Sven Schippling; Axel Petzold Journal: PLoS One Date: 2012-04-19 Impact factor: 3.240