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Séminaire impromptu - Friedemann PAULRetinal Imaging in Neurology-current research and clinical applications

Abstract :


 Imaging of the retina with the help of high resolution spectral domain optical coherence tomography (OCT) has leveraged
both clinical and preclinical investigations of inflammatory and autoimmune processes that affect retinal tissue. In the past 10 years, our understanding of the pathophysiology of retinal damage and how this relates to global disease burden and clinical disability in neuroimmunological diseases such as optic neuritis, multiple sclerosis, neuromyelitis optica, Susac syndrome and others has substantially increased. Consequently, OCT is increasingly used to assess patients with autoimmune conditions of the central nervous system in clinical routine and is also implemented as outcome tool in clinical trials investigating the visual system. In preclinical research, OCT retinal imaging is used in animal models to deepen our understanding of the pathophysiologic mechanisms prevailing in these conditions.
The presentation will review both preclinical data and clinical applications of retinal imaging techniques and will discuss future research questions.

Selected publications

1. Disruption of the leptomeningeal blood barrier in neuromyelitis optica spectrum disorder. Asgari N,
Flanagan EP, Fujihara K, Kim HJ, Skejoe HP, Wuerfel J, Kuroda H, Kim SH, Maillart E, Marignier R,
Pittock SJ, Paul F, Weinshenker BG. Neurol Neuroimmunol Neuroinflamm. 2017 Apr 21;4(4):e343.


2. Microstructural visual system changes in AQP4-antibody-seropositive NMOSD. Oertel FC, Kuchling J, Zimmermann H, Chien C, Schmidt F, Knier B, Bellmann-Strobl J, Korn T, Scheel M, Klistorner A,
Ruprecht K, Paul F, Brandt AU.Neurol Neuroimmunol Neuroinflamm. 2017 Feb 22;4(3):e334.


3. Severe structural and functional visual system damage leads to profound loss of vision-related quality of life in patients with neuromyelitis optica spectrum disorders. Schmidt F, Zimmermann H, Mikolajczak J, Oertel FC, Pache F, Weinhold M, Schinzel J, Bellmann-Strobl J, Ruprecht K, Paul F, Brandt AU. Mult Scler Relat Disord. 2017 Jan;11:45-50.


4. Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response.
Stellmann JP, Krumbholz M, Friede T, Gahlen A, Borisow N, Fischer K, Hellwig K, Pache F, Ruprecht
K, Havla J, Kümpfel T, Aktas O, Hartung HP, Ringelstein M, Geis C, Kleinschnitz C, Berthele A,
Hemmer B, Angstwurm K, Young KL, Schuster S, Stangel M, Lauda F, Tumani H, Mayer C, Zeltner L,
Ziemann U, Linker RA, Schwab M, Marziniak M, Then Bergh F, Hofstadt-van Oy U, Neuhaus O, Zettl
U, Faiss J, Wildemann B, Paul F, Jarius S, Trebst C, Kleiter I; NEMOS (Neuromyelitis Optica Study
Group).J Neurol Neurosurg Psychiatry. 2017 Jun 1. pii: jnnp-2017-315603. doi: 10.1136/jnnp-2017-
315603. [Epub ahead of print]


5. Diagnostic criteria for Susac syndrome. Kleffner I, Dörr J, Ringelstein M, Gross CC, Böckenfeld Y,
Schwindt W, Sundermann B, Lohmann H, Wersching H, Promesberger J, von Königsmarck N, Alex A,
Guthoff R, Frijns CJ, Kappelle LJ, Jarius S, Wildemann B, Aktas O, Paul F, Wiendl H, Duning T;
European Susac Consortium (EuSaC).J Neurol Neurosurg Psychiatry. 2016 Dec;87(12):1287-1295.

6. Longitudinal Intravital Imaging of the Retina Reveals Long-term Dynamics of Immune Infiltration and
Its Effects on the Glial Network in Experimental Autoimmune Uveoretinitis, without Evident Signs of
Neuronal Dysfunction in the Ganglion Cell Layer. Bremer D, Pache F, Günther R, Hornow J, Andresen
V, Leben R, Mothes R, Zimmermann H, Brandt AU, Paul F, Hauser AE, Radbruch H, Niesner R. Front
Immunol. 2016 Dec 23;7:642

Scientific focus :

Research Areas

1. Imaging tools in clinical neuroimmunology to improve diagnosis, differential diagnosis and individual disease prediction (MRI, optical coherence tomography, ultrahigh field MRI)

2. Differential diagnosis of autoimmune CNS conditions (MS, NMO, Susac syndrome, autoimmune encephalitides)

3. Neurodegeneration and neuroprotection in multiple sclerosis and animal models including clinical trials

4. Environmental factors and lifestyle interventions in multiple sclerosis (vitamin D, dietary interventions, exercise)

5 The visual system in multiple sclerosis and other neurological disorder