Optical coherence tomography and visual evoked potentials in pediatric MS.
Optical coherence tomography and visual evoked potentials in pediatric MS.
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DOI：
10.1212/nxi.0000000000000356
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发表时间：
2017-07
期刊：
影响因子：
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通讯作者：
Banwell BL
中科院分区：
文献类型：
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作者：
Waldman AT;Liu GT;Lavery AM;Liu G;Gaetz W;Aleman TS;Banwell BL
为了确定光学相干断层扫描（OCT）和模式反转视觉诱发电位（pVEPs）检测儿科发病多发性硬化症视觉通路参与的相对能力，儿科发病多发性硬化症参与者（发病<18岁）和健康对照（hc）接受OCT （Cirrus HD-OCT）和pVEPs。测定视网膜神经纤维层（RNFL）、神经节细胞层至内丛状层（GCL-IPL）和P100 pVEP潜伏期。使用广义估计方程模型比较各组，调整年龄和眼间相关性。24名儿童MS参与者，14名有单眼（8名）或双眼（6名）远端视神经炎（ON）病史的参与者，以及24名hc参与者。50%的ON眼和5%的non-ON眼的RNFL变薄（<83 μm，低于HC眼2 SDs）。有58%的双眼和55%的非双眼出现了延长的VEP潜伏期（10 ~ 109毫秒）。ON的临床病史预测RNFL （p < 0.001）和GCL-IPL变薄（p = 0.011），而MS儿童pVEP潜伏期延长与ON病史无关。OCT和pvep提供了互补但不同的见解。在临床视神经病变的背景下，OCT对视网膜的变化很敏感，而pvep对检测MS儿童视觉通路的弥散性病变很有用。
To determine the relative ability of optical coherence tomography (OCT) and pattern-reversal visual evoked potentials (pVEPs) to detect visual pathway involvement in pediatric-onset MS. Pediatric-onset MS participants (onset <18 years) and healthy controls (HCs) underwent OCT (Cirrus HD-OCT) and pVEPs. Retinal nerve fiber layer (RNFL), ganglion cell layer to inner plexiform layer (GCL-IPL), and P100 pVEP latency were measured. Generalized estimating equation models were used to compare the groups, adjusting for age and intereye correlations. Twenty-four pediatric MS participants, 14 with a history of remote (>6 months) optic neuritis (ON) in one eye (8 participants) or both the eyes (6 participants), and 24 HCs were enrolled. RNFL thinning (<83 μm, 2 SDs below HC eyes) occurred in 50% of ON eyes vs 5% of non-ON eyes. Prolonged VEP latency (>109 msec) occurred in 58% of ON eyes and 55% of non-ON eyes. A clinical history of ON predicted RNFL (p < 0.001) and GCL-IPL thinning (p = 0.011), whereas prolonged pVEP latency in children with MS occurred independent of ON history. OCT and pVEPs provide complementary but distinct insights. OCT is sensitive to retinal changes in the context of clinical ON, whereas pVEPs are useful to detect disseminated lesions of the visual pathway in children with MS.