Retinal Neuro-vascular Coupling in Patients With Multiple Sclerosis
Multiple sclerosis (MS) affects approximately 2.3 million patients worldwide, with a global median prevalence of 33 per 100,000. MS is diagnosed at an average of 30 years and affects twice as many women as men. MS is traditionally diagnosed by the presentation of lesions of the central nervous system, disseminated in time and in space, proven by clinical examination and magnetic resonance imaging. Several anatomical parameters in the eye, both vascular and neural, have been found to be altered in MS patients.
Because of its unique optical properties, the eye offers the possibility of the non-invasive assessment of both structural and functional alterations in neuronal tissue. As the neuro-retina is part of the brain, it does not come as a surprise that neuro-degenerative changes in the brain are accompanied by structural and possibly also functional changes in the neuro-retina and the ocular vasculature.
The current study seeks to test the hypothesis that beside the known anatomical changes, also functional changes can be detected in the retina of patients with MS. For this purpose, flicker light induced hyperemia will be measured in the retina as a functional test to assess the coupling between neural activity and blood flow. Further, structural parameters such as retinal nerve fiber layer thickness and function parameters such as ocular blood flow and retinal oxygenation will be assessed and compared to age and sex matched controls.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Gerhard Garhöfer, MD
- Phone Number: 29810 0043140400
- Email: gerhard.garhoefer@medunwien.ac.at
Study Locations
-
-
-
Vienna, Austria, 1090
- Recruiting
- Department of Clinical Pharmacology, Medical University of Vienna
-
Contact:
- Gerhard Garhöfer, MD
- Phone Number: 29810 0043140400
-
Principal Investigator:
- Gerhard Garhöfer, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria for healthy subjects:
- Men and women aged over 18 years
- Non-smokers
- Normal findings in the medical history unless the investigator considers an abnormality to be clinically irrelevant
- Normal ophthalmic findings, ametropy < 6 Dpt.
Inclusion criteria for patients with MS:
- Men and women aged over 18 years
- Diagnosis of relapsing-remitting multiple sclerosis (RRMS) according to clinical evaluation and McDonald criteria (revision 2010)
- History of AON in one eye at least one year ago
- Non-smokers
- Normal ophthalmic findings, ametropy < 6 Dpt.
- Adequate visual acuity to allow participation in the ocular blood flow measurements
- A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except MS therapy itself which will be recorded separately) for at least 30 days prior inclusion, if considered relevant by the investigator.
Any of the following will exclude a healthy subject from the study:
- Diagnosis of "possible MS" according to the McDonald criteria (revision 2010)
- Presence or history of a severe medical condition as judged by the clinical investigator
- Untreated Arterial hypertension
- History or family history of epilepsy
- Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
- Family history of MS, optic neuritis, neuromyelitis optica (NMO, Devic disease) or NMO spectrum disorders
- History of inflammatory or infectious disease of central nervous system
- Best corrected visual acuity < 0.5 Snellen
- Ametropy ≥ 6Dpt
- Pregnancy or planned pregnancy
- Alcoholism or substance abuse
Any of the following will exclude a patient from the study:
- Presence or history of a severe medical condition other than MS as judged by the clinical investigator
- History of neuromyelitis optica (NMO, Devic disease) or NMO spectrum disorders
- History of inflammatory or infectious disease of central nervous system other than MS
- Untreated Arterial hypertension
- History or family history of epilepsy
- Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
- Best corrected visual acuity < 0.5 Snellen
- Ametropy ≥ 6 Dpt
- Pregnancy, planned pregnancy
- Significant neurological disease other than MS, if considered relevant by the investigator
- Alcoholism or substance abuse
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Patients with MS
Patients with Multiple Sclerosis
|
Retinal vessel diameters and oxygen saturation will be measured with the DVA device.
Retinal blood flow will be assessed using FDOCT.
Nerve fiber layer thickness and central retinal thickness will be measured using OCT.
Retinal microvasculature will be assessed using OCTA.
|
|
Experimental: Healthy control subjects
Healthy age- and sex- matched control subjects
|
Retinal vessel diameters and oxygen saturation will be measured with the DVA device.
Retinal blood flow will be assessed using FDOCT.
Nerve fiber layer thickness and central retinal thickness will be measured using OCT.
Retinal microvasculature will be assessed using OCTA.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Flicker induced increase in retinal blood flow
Time Frame: 1 day
|
Response of retinal blood flow to flicker light assessed with FDOCT
|
1 day
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Retinal vessel diameters
Time Frame: 1 day
|
Response of retinal vessel diameters to flicker light assessed with DVA
|
1 day
|
|
Retinal oxygen saturation
Time Frame: 1 day
|
Retinal oxygen saturation measured with DVA
|
1 day
|
|
Retinal nerve fiber layer thickness
Time Frame: 1 day
|
Retinal nerve fiber layer thickness measured using OCT
|
1 day
|
|
Layer specific flow signal
Time Frame: 1 day
|
Retinal layer specific blood flow signal measured using OCTA
|
1 day
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Gerhard Garhöfer, MD, Department of Clinical Pharmacology, Medical University of Vienna
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Pathologic Processes
- Neuromuscular Diseases
- Autoimmune Diseases
- Immune System Diseases
- Peripheral Nervous System Diseases
- Eye Diseases
- Demyelinating Autoimmune Diseases, CNS
- Autoimmune Diseases of the Nervous System
- Demyelinating Diseases
- Optic Nerve Diseases
- Cranial Nerve Diseases
- Multiple Sclerosis
- Sclerosis
- Multiple Sclerosis, Relapsing-Remitting
- Neuritis
- Optic Neuritis
Other Study ID Numbers
Other Study ID Numbers
- OPHT-210417
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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