Radial diffusivity in remote optic neuritis discriminates visual outcomes
Radial diffusivity in remote optic neuritis discriminates visual outcomes
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DOI：
10.1212/wnl.0b013e3181e0434d
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发表时间：
2010-05-25
期刊：
影响因子：
9.9
通讯作者：
Song, S. -K.
中科院分区：
文献类型：
--
作者：
Naismith, R. T.;Xu, J.;Song, S. -K.
目的：扩散张量成像 (DTI) 量化组织内水的布朗运动。本研究的目的是测试在视神经炎 (ON) 远期发作后，是否可以通过 DTI 参数的改变来检测视神经内髓磷脂和轴突的破坏，以及这些改变是否与视力丧失相关。方法：70 名有 ON > 6 个月病史的受试者接受了视神经 DTI、视力 (VA) 和对比敏感度 (CS) 评估以及视觉诱发电位的实验室测量(VEP) 和光学相干断层扫描 (OCT)。结果：径向扩散率 (RD) 与视力 (r = -0.61)、Pelli-Robson CS (r = -0.60)、5% CS (r = 0.61)、OCT (r = -0.78)、VEP 潜伏期 (r = 0.61) 和 VEP 幅度 (r = -0.46) 相关。 RD 在所有视觉结果类别中区分未受影响的同伴神经和受影响的神经。 RD 还区分了因轻度视力障碍而恢复正常的神经，以及因严重视力丧失而恢复正常的神经。 RD 将健康对照与 ON 后临床受影响的神经和未受影响的神经区分开来。 RD 区分了 5% CS 结果的所有类别以及 Pelli-Robson CS 的所有类别（轻度受影响的正常恢复除外）。结论：通过扩散张量成像 (DTI) 检测到的视神经径向扩散率 (RD) 增加与视神经炎后视力成比例下降相关。 RD 可以将健康的控制神经与受影响和未受影响的其他神经区分开来。 RD 可以区分受影响眼睛内的视力恢复类别。通过 DTI 评估的视神经损伤得到光学相干断层扫描和视觉诱发电位的证实。神经病学(R)2010; 74：1702-1710
Objective: Diffusion tensor imaging (DTI) quantifies Brownian motion of water within tissue. The goal of this study was to test whether, following a remote episode of optic neuritis (ON), breakdown of myelin and axons within the optic nerve could be detected by alterations in DTI parameters, and whether these alterations would correlate with visual loss.Methods: Seventy subjects with a history of ON >6 months prior underwent DTI of the optic nerves, assessment of visual acuities (VA) and contrast sensitivities (CS), and laboratory measures of visual evoked potentials (VEP) and optical coherence tomography (OCT).Results: Radial diffusivity (RD) correlated with visual acuity (r = -0.61), Pelli-Robson CS (r = -0.60), 5% CS (r = 0.61), OCT (r = -0.78), VEP latency (r = 0.61), and VEP amplitude (r = -0.46). RD differentiated the unaffected fellow nerves from affected nerves in all visual outcome categories. RD also discriminated nerves with recovery to normal from mild visual impairment, and those with mild impairment from profound visual loss. RD differentiated healthy controls from both clinically affected nerves and unaffected fellow nerves after ON. RD differentiated all categories of 5% CS outcomes, and all categories of Pelli-Robson CS with the exception of normal recovery from mildly affected.Conclusions: Increased optic nerve radial diffusivity (RD) detected by diffusion tensor imaging (DTI) was associated with a proportional decline in vision after optic neuritis. RD can differentiate healthy control nerves from both affected and unaffected fellow nerves. RD can discriminate among categories of visual recovery within affected eyes. Optic nerve injury as assessed by DTI was corroborated by both optical coherence tomography and visual evoked potentials. Neurology (R) 2010; 74: 1702-1710