Distinctive retinal nerve fibre layer and vascular changes in neuromyelitis optica following optic neuritis
Distinctive retinal nerve fibre layer and vascular changes in neuromyelitis optica following optic neuritis
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DOI：
10.1136/jnnp.2008.166207
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发表时间：
2009-09-01
影响因子：
11
通讯作者：
Cree, B. A. C.
中科院分区：
文献类型：
--
作者：
Green, A. J.;Cree, B. A. C.
患者和方法：本文是一项横断面研究，比较了20例多发性硬化（MS）和16例有视神经炎（NMO）病史的视神经炎（ON）患者的视网膜特征（发作时的视力>20/100）使用光学相干断层扫描（OCT）和眼底镜检查进行年龄和性别匹配。（1）血管变化，包括乳头周围血管树的衰减（3/40只MS眼，22/32只NMO眼; p = 0.001）和局灶性小动脉狭窄（0/40只MS眼和9/32只NMO眼; p，0.0001），（2）较低的平均神经纤维层（NFL）厚度（59.2 μ m与MS中的82.0 μ m相比; p = 0.004）和（3）在控制最终视力后，NFL变薄近两倍（32.1与17.6 μ m; p = 0.004）。与MS相比，NMO患者的NFL有更严重和弥漫性轴索损伤。结论：这些NFL和眼底镜检查结果表明，在NMO中看到的一些损伤可能是血管介导的。这些视网膜内血管的变化使人联想到以前在尸检中报道的视神经和脊髓血管壁增厚。如果视网膜的变化与脊髓和视神经的变化有共同的病理学，这些观察结果表明，血管的变化可能在生命过程中是可检测的。
Patients and methods: This is a cross sectional study comparing the retinal features of optic neuritis (ON) between 20 multiple sclerosis (MS) and 16 neuromyelitis optica (NMO) patients with a history of ON (visual acuity at time of attack >20/100) matched for age and gender using optical coherence tomography (OCT) and fundoscopy.Results: Compared with MS, NMO patients often had: (1) vascular changes, including attenuation of the peripapillary vascular tree (3/40 MS eyes, 22/32 NMO eyes; p = 0.001) and focal arteriolar narrowing (0/40 MS eyes and 9/32 NMO eyes; p, 0.0001), (2) a lower average nerve fibre layer (NFL) thickness (59.2 mu m compared with 82.0 mu m in MS; p = 0.004) and (3) nearly twice the NFL thinning after controlling for final visual acuity (32.1 vs 17.6 mu m; p = 0.004). Patients with NMO had more severe and diffuse axonal injury of the NFL compared with MS.Conclusion: These NFL and fundoscopic findings suggest that some of the injury seen in NMO may be vascularly mediated. These inner retinal vascular changes are reminiscent of blood vessel wall thickening previously reported in the optic nerve and spinal cord at autopsy. If the retinal changes share a common pathology to those in the spinal cord and optic nerve, these observations suggest that vascular changes may be detectable during life.