Optical coherence tomography and disease subtype in multiple sclerosis
Optical coherence tomography and disease subtype in multiple sclerosis
复制标题
DOI：
10.1212/01.wnl.0000294876.49861.dc
复制
发表时间：
2007-11-27
期刊：
影响因子：
9.9
通讯作者：
Calabresi, P. A.
中科院分区：
文献类型：
--
作者：
Pulicken, M.;Gordon-Lipkin, E.;Calabresi, P. A.
目的：检测有和无急性视神经炎（ON）病史的多发性硬化症（MS）患者的视网膜神经纤维层（RNFL）厚度、黄斑体积（MV）和视力。方法：采用光学相干断层扫描（OCT）测量326只MS和94只对照眼的RNFL厚度。在队列的一个子集中进行MV和视力测试。MS亚型分为复发缓解型（RRMS，n = 135）、原发进展型（PPMS，n = 12）和继发进展型（SPMS，n = 16）。MS ON眼的未受影响的对侧眼（93.9 μ m）（p < 0.01）和没有ON病史的MS患者（95.9 μ m）（p < 0.05）也具有降低的RNFL。与对照组相比，RRMS（94.4 μ m）（p < 0.001）、PPMS（88.9 μ m）（p < 0.01）和SPMS（81.8 μ m）（p < 0.0001）（调整了年龄和疾病持续时间）具有降低的RNFL。复发与进行性MS亚型相比，视乳头周围视网膜象限内RNFL厚度存在显著差异。MS ON眼MV降低（6.2毫米（3））（p < 0.0001）和SPMS受试者（6.2毫米（3））（p < 0.05）与对照组相比（6.8 mm（3））。结论：视网膜神经纤维层（RNFL）在多发性硬化（MS）视神经炎（ON）眼、MS ON患者的未受影响的对侧眼中显著减少，在我们的队列中，MS眼未受ON影响。黄斑体积（MV）显示MS ON眼的显著减少。进行性MS病例显示RNFL和MV比复发缓解型MS更显著降低。OCT是检测MS患者RNFL和MV亚临床变化的有前途的工具，应在纵向研究中作为MS视网膜病理学的潜在生物标志物进行检查。
Objective: To examine retinal nerve fiber layer (RNFL) thickness, macular volumes (MV), and visual acuity in multiple sclerosis (MS) eyes, with and without history of acute optic neuritis (ON).Methods: RNFL thickness was measured in 326 MS and 94 control eyes using optical coherence tomography (OCT). MV and vision testing were done in a subset of the cohort. MS subtype was classified as relapsing- remitting (RRMS, n = 135), primary progressive (PPMS, n = 12), and secondary progressive (SPMS, n = 16).Results: MS ON eyes had decreased RNFL thickness (84.2 mu m) compared to controls (102.7 mu m) (p < 0.0001). Unaffected fellow eyes of MS ON eyes (93.9 mu m) (p < 0.01) and patients with MS with no history of ON (95.9 mu m) (p < 0.05) also had decreased RNFL. RRMS (94.4 mu m) (p < 0.001), PPMS (88.9 mu m) (p < 0.01), and SPMS (81.8 mu m) (p < 0.0001) (adjusted for age and duration of disease) had decreased RNFL compared to controls. There were significant differences in RNFL thickness within quadrants of peripapillary retina comparing relapsing to progressive MS subtypes. MV was decreased in MS ON eyes (6.2 mm(3)) (p < 0.0001) and SPMS subjects (6.2 mm(3)) (p < 0.05) compared to controls (6.8 mm(3)).Conclusion: Retinal nerve fiber layer (RNFL) is significantly decreased in multiple sclerosis (MS) optic neuritis (ON) eyes, unaffected fellow eyes of patients with MS ON, and MS eyes not affected by ON in our cohort. Macular volumes (MV) showed a significant decrease in MS ON eyes. Progressive MS cases showed more marked decreases in RNFL and MV than relapsing-remitting MS. OCT is a promising tool to detect subclinical changes in RNFL and MV in patients with MS and should be examined in longitudinal studies as a potential biomarker of retinal pathology in MS.