Retinal Layer Segmentation in Patients with Multiple Sclerosis Using Spectral Domain Optical Coherence Tomography
Retinal Layer Segmentation in Patients with Multiple Sclerosis Using Spectral Domain Optical Coherence Tomography
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DOI：
10.1016/j.ophtha.2013.09.035
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发表时间：
2014-02-01
期刊：
影响因子：
13.7
通讯作者：
Pablo, Luis E.
中科院分区：
文献类型：
--
作者：
Garcia-Martin, Elena;Polo, Vicente;Pablo, Luis E.
目的：目的：应用新的光谱域光学相干断层扫描（OCT）分割技术，对多发性硬化（MS）患者黄斑旁区视网膜10层厚度进行定量分析。研究哪一层对检测MS患者的神经变性具有更好的灵敏度。设计：观察性横断面研究。参与者：MS患者（n = 204）和年龄匹配的健康受试者（n = 138）。海德堡，德国），以获得自动分割的所有视网膜层在一个旁的扫描在1个随机选择的眼睛的每个participant.Main结果Measures：在每只眼睛的厚度512个旁点的10个视网膜层，并计算每层的平均厚度，并与MS患者和健康受试者之间进行比较。重复分析，比较有和没有以前的视神经炎的MS患者。进行相关性分析以评估MS患者中每个视网膜层平均厚度、疾病持续时间和功能障碍之间的关联。进行逻辑回归分析以确定哪一层对检测MS患者中的神经变性提供更好的灵敏度。除内界膜外，MS患者视网膜各层均较正常人薄（P< 0.05）。有视神经炎史者视网膜内层（神经纤维层、神经节细胞层、内丛状层和内核层）受影响更大（P< 0.05）。视网膜神经纤维层和神经节细胞层厚度与MS患者的功能障碍评分呈负相关。神经节细胞层和内丛状层厚度可以预测MS患者的轴突损伤。结论：基于Spectralis OCT分割技术的分析显示MS患者视网膜层萎缩，尤其是内层。神经节细胞和内丛状层的减少预测MS患者的轴突损伤更大。（C）2014由美国眼科学会。
Purpose: To evaluate the thickness of the 10 retinal layers in the paramacular area of patients with multiple sclerosis (MS) compared with healthy subjects using the new segmentation technology of spectral domain optical coherence tomography (OCT). To examine which layer has better sensitivity for detecting neurodegeneration in patients with MS.Design: Observational, cross-sectional study.Participants: Patients with MS (n = 204) and age-matched healthy subjects (n 138).Methods: The Spectralis OCT system (Heidelberg Engineering, Inc., Heidelberg, Germany) was used to obtain automated segmentation of all retinal layers in a parafoveal scan in 1 randomly selected eye of each participant, using the new segmentation application prototype.Main Outcome Measures: The thicknesses of 512 parafoveal points in the 10 retinal layers were obtained in each eye, and the mean thickness of each layer was calculated and compared between patients with MS and healthy subjects. The analysis was repeated, comparing patients with MS with and without previous optic neuritis. Correlation analysis was performed to evaluate the association between each retinal layer mean thickness, duration of disease, and functional disability in patients with MS. A logistic regression analysis was performed to determine which layer provided better sensitivity for detecting neurodegeneration in patients with MS.Results: All retinal layers, except the inner limiting membrane, were thinner in patients with MS compared with healthy subjects (P< 0.05). Greater effects were observed in the inner retinal layers (nerve fiber, ganglion cells, inner plexiform, and inner nuclear layers) of eyes with previous optic neuritis (P< 0.05). The retinal nerve fiber layer and ganglion cell layer thicknesses were inversely correlated with the functional disability score in patients with MS. The ganglion cell layer and inner plexiform layer thicknesses could predict axonal damage in patients with MS.Conclusions: Analysis based on the segmentation technology of the Spectralis OCT revealed retinal layer atrophy in patients with MS, especially of the inner layers. Reduction of the ganglion cell and inner plexiform layers predicted greater axonal damage in patients with MS. (C) 2014 by the American Academy of Ophthalmology.