Vision and Vision-Related Measures in Progressive Multiple Sclerosis
Vision and Vision-Related Measures in Progressive Multiple Sclerosis
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DOI：
10.3389/fneur.2019.00455
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发表时间：
2019-05-03
影响因子：
3.4
通讯作者：
Levin, Netta
中科院分区：
文献类型：
--
作者：
Backner, Yael;Petrou, Panayiota;Levin, Netta
背景：在过去的几年中，人们对使用视觉测量作为多发性硬化症（MS）预后和跟踪的有用工具越来越感兴趣。视神经炎（ON）是该疾病的一种普遍且经常出现的症状，以及独立于ON（视辐射病变）的后视系统损伤的高发生率，使视觉系统成为此类努力的主要候选。然而，虽然视觉系统在MS的早期阶段提供了一个方便的模型，但由于累积的疾病负荷，在这些阶段可能真实的过程可能随着疾病的进展而急剧变化。在这里，我们研究了视觉相关工具是否反映了视觉通路的脱髓鞘和轴突损伤，并可能用于评估进展性多发性硬化症（MS）患者的临床设置，在这些患者中，疾病负荷可能改变早期图像。方法：48例有或无视神经炎（ON）的进展性MS患者在两个时间点接受了一系列行为测试、视觉诱发电位（VEP）测试、光学相干断层扫描（OCT）和结构MRI扫描。分析了两次访问之间的数据稳定性以及行为和电生理数据之间的相关性。结果：各指标均稳定。在受影响的眼睛和其他ON患者的眼睛之间以及受影响的眼睛和未受影响的眼睛之间的VEP潜伏期的所有测量中都发现了显著差异。运动知觉与开启眼和非开启眼的潜伏期存在差异。视网膜神经纤维层厚度与非ON眼的潜伏期相关，而与ON眼和ON眼的潜伏期无关。病变负荷在ON和非ON患者之间没有差异。结论：随着时间的推移，ON仍然会在患者的视觉系统中留下印记，与其他眼睛相比，受影响眼睛的所有视觉测量都显着降低。运动知觉，反映沿视觉通路的髓鞘形成水平，显示其有用性
Background: Over the last few years there has been growing interest in use of visual measures as useful tools for multiple sclerosis (MS) prognosis and tracking. Optic neuritis (ON) being a prevalent and often-presenting symptom of the disease, as well as the high occurrence rate of posterior visual system damage independent of ON (optic radiation lesions), make the visual system a prime candidate for such endeavors. However, while the visual system makes for a convenient model in early stages of MS, processes which may be true in those stages may drastically change as the disease progresses, due to accumulated disease load. Here, we examine whether vision-related tools reflect demyelinative and axonal damage of the visual pathways and may be used for assessment in the clinical setup in progressive multiple sclerosis (MS) patients, in whom disease load may alter the early stage picture.Methods: Forty-eight progressive MS patients, with and without prior optic neuritis (ON), underwent a battery of behavioral tests, visual evoked potential (VEP) tests, optical coherence tomography (OCT), and structural MRI scans, at two time-points. Data were analyzed for stability between visits and for correlation between behavioral and electrophysiological data.Results: All measures were stable between visits. Significant differences were found in all measures between the affected and fellow eyes of ON patients and in VEP latencies between the affected and non-ON eyes. Motion perception differentially correlated with latencies of both ON eyes and with the non-ON eyes. Retinal nerve fiber layer thickness correlated with the latencies of non-ON eyes but not of either ON eye. No difference in lesion load was found between the ON and non-ON patients.Conclusions: ON still leaves its mark in the patient's visual system over time, with all visual measures of the affected eyes notably reduced compared to fellow eyes. Motion perception, reflecting myelination level along the visual pathway, shows its usefulness