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The International Multiple Sclerosis Visual System Consortium

Advancing Visual System Research in Multiple Sclerosis

Balcer, Laura J., MD, MSCE; Balk, Lisanne J., PhD; Brandt, Alexander U., MD; Calabresi, Peter A., MD; Martinez-Lapiscina, Elena H., MD, PhD; Nolan, Rachel C., BA; Paul, Friedemann, MD; Petzold, Axel, MD, PhD; Saidha, Shiv, MBBCh, MD, MRCPI,

Section Editor(s): Costello, Fiona MD, FRCP(C)

doi: 10.1097/WNO.0000000000000732
Disease of the Year: Multiple Sclerosis

Background: The International Multiple Sclerosis Visual System Consortium (IMSVISUAL) was formed in November 2014 with the primary goal of improving research, care, and education regarding the role of the visual system in multiple sclerosis (MS) and related disorders.

Methods: In this review, we describe the formation, goals, activities, and structure of IMSVISUAL, as well as the relationship of IMSVISUAL with the Americas Committee for Treatment and Research in MS (ACTRIMS). Finally, we provide an overview of the work IMSVISUAL has completed to date, as well as an outline of research projects ongoing under the auspices of IMSVISUAL.

Results: IMSVISUAL has 140 members worldwide and continues to grow. Through IMSVISUAL-related research, optical coherence tomography (OCT)-derived peripapillary retinal nerve fiber layer (pRNFL) thinning has been established as a predictor of future disability in MS. IMSVISUAL has also developed guidelines for reporting OCT studies in MS. Moreover, a systematic review performed by IMSVISUAL found that not only are pRNFL and ganglion cell + inner plexiform layer (GCIPL) thicknesses reduced in patients with MS (particularly in eyes with prior optic neuritis [ON]), but that inner nuclear layer measures may be higher among MS ON eyes, relative to healthy control eyes. Currently, there are several ongoing IMSVISUAL projects that will establish a role for visual outcomes in diagnosing MS and quantifying the effects of emerging therapies in clinical trials.

Conclusions: The development of IMSVISUAL represents a major collaborative commitment to defining the role of visual outcomes in high-quality, large-scale studies that generate definitive and instructive findings in the field of MS. As a consortium, IMSVISUAL has completed several international collaborative projects, is actively engaged in numerous ongoing research studies, and is committed to expanding the role of vision research in MS and related disorders.

Departments of Neurology, Ophthalmology & Population Health (LJ Balcer), New York University School of Medicine, New York University, New York, New York; Department of Neurology (LJ Balk, AP), Amsterdam UMC—Location VUmc, Amsterdam, the Netherlands; Department of Neurology (AUB, FP), NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Neurology (PAC, SS), Johns Hopkins University, Baltimore, Maryland; Department of Neurology (EHM-L), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Department of Population Health (RCN), Sackler Institute for Biomedical Sciences, New York University, New York, NY, USA & Department of Neurology, New York University School of Medicine, New York University, New York, New York; and Department of Neurology (AP), University College London, the National Hospital for Neurology and Neurosurgery, Moorfields Eye Hospital, London, United Kingdom.

Address correspondence to Shiv Saidha, MBBCh, MD, MRCPI, Division of Neuroimmunology and Neurological Infections, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287; E-mail:

F. Paul has received honoraria and research support from Alexion, Bayer, Biogen, Chugai, MerckSerono, Novartis, Genyzme, MedImmune, Shire, and Teva, and serves on scientific advisory boards for Alexion, MedImmune, and Novartis. He has received funding from Deutsche Forschungsgemeinschaft (DFG Exc 257), Bundesministerium für Bildung und Forschung (Competence Network Multiple Sclerosis), Guthy Jackson Charitable Foundation, EU Framework Program 7, and National Multiple Sclerosis Society of the USA. FP serves on advisory boards and steering committees for Novartis and MedImmune and is Associate Editor of Neurology, Neuroimmunology, and Neuroinflammation and Academic Editor of PLoS One. A. Petzod is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health. He is member of the steering committee for the OCTiMS study (Novartis) and performed OCT QC for the PASSOS study (Novartis) and received consulting fees. S. Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology and has served on scientific advisory boards for Biogen Idec, Genzyme, Genentech Corporation, EMD Serono, and Novartis. He is the PI of investigator-initiated studies funded by Genentech Corporation and Biogen Idec, and received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC, a retinal imaging device developer. He is also the site investigator of a trial sponsored by MedDay Pharmaceuticals.

L. J. Balcer has received investigator-initiated research grant funding from Biogen. L. J. Balk has received an institutional research grant from TEVA. A. U. Brandt is a cofounder and shareholder of the startups Motognosis and Nocturne. He is named as inventor on several patent applications description MS serum biomarkers, perceptive visual computing, and retinal image analysis. P. A. Calabresi has received personal honorariums for consulting from Biogen and Disarm Therapeutics. He is PI on research grants to Johns Hopkins from MedImmune, Annexon, Biogen, and Genzyme. E. H. Martinez-Lapiscina has received speaking honoraria from Roche, Biogen, Sanofi-Genzyme, and Novartis, and travel reimbursement from Roche, Sanofi-Genzyme, and Biogen, over the last 3 years. She has received consulting fees from Roche and Sanofi-Genzyme and unrestricted grants from Fundació Privada Cellex. She has received investigator-initiated research grant funding from Sanofi-Genzyme and investigator-initiated educational grant from Novartis. The remaining authors report no conflicts of interest.

L. J. Balcer, L. J. Balk, A. U. Brandt, P. A. Calabresi, E. H. Martinez-Lapiscina, R. Nolan, F. Paul, A. Petzold, and S. Saidha contributed equally and are listed in alphabetical order.

© 2018 by North American Neuro-Ophthalmology Society