Retinal damage and vision loss in African American multiple sclerosis patients.
Retinal damage and vision loss in African American multiple sclerosis patients.
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DOI：
10.1002/ana.24308
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发表时间：
2015-02
影响因子：
11.2
通讯作者：
Calabresi, Peter A.
中科院分区：
文献类型：
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作者：
Kimbrough, Dorlan J.;Sotirchos, Elias S.;Wilson, James A.;Al-Louzi, Omar;Conger, Amy;Conger, Darrel;Frohman, Teresa C.;Saidha, Shiv;Green, Ari J.;Frohman, Elliot M.;Balcer, Laura J.;Calabresi, Peter A.
确定非裔美国人（AA）多发性硬化（MS）患者是否比白人美国人（CA）MS患者表现出更多的视网膜损伤和视力损害。2008年至2012年间，在三家学术医院招募了687例MS患者（81例AA）和110例健康对照（HC）受试者（14例AA）。使用混合效应回归模型，我们比较了高和低对比度视力（HCVA和LCVA）和高清晰度光谱域光学相干断层扫描（Cirrus-OCT）测量的自认为AA和CA血统的MS患者之间的视网膜结构。在HC中，AA的基线视乳头周围视网膜神经纤维层厚度（RNFL）大于6.1 μm（p = 0.047），而神经节细胞/内网状层（GCIP）厚度不存在种族差异。在MS患者中，基线RNFL没有种族差异，AA患者的GCIP薄3.98 μm（p = 0.004）。与CA相比，AA具有更快的RNFL和GCIP变薄速率（分别为p = 0.004和p= 0.046）。AA MS患者的基线HCVA较低（p = 0.02），每年病程的LCVA较差（p= 0.039）。在有急性视神经炎（AON）病史的患者中，AA患者的HCVA损失大于CA患者（p = 0.012）。这项多中心研究提供了客观证据，表明与CA MS患者相比，AA MS患者表现出加速的视网膜损伤。自我认定的AA血统与MS相关视力障碍恶化相关，特别是在AON病史的背景下，这表明AA MS患者或其中的亚群中的炎性疾病病程更具侵袭性。
To determine whether African-American (AA) multiple sclerosis (MS) patients exhibit more retinal damage and visual impairment compared to Caucasian-American (CA) MS patients. 687 MS patients (81 AA) and 110 healthy control (HC) subjects (14 AA) were recruited at three academic hospitals between 2008 and 2012. Using mixed effects regression models, we compared high and low contrast visual acuity (HCVA and LCVA) and high-definition spectral-domain optical coherence tomography (Cirrus-OCT) measures of retinal architecture between MS patients of self-identified AA and CA ancestry. In HC, baseline peripapillary retinal nerve fiber layer thickness (RNFL) was 6.1 μm greater in AA (p = 0.047), while ganglion cell / inner plexiform layer (GCIP) thickness did not differ by race. In MS patients, baseline RNFL did not differ by race, and GCIP was 3.98 μm thinner in AA (p = 0.004). AA had faster RNFL and GCIP thinning rates compared to CA (p = 0.004 and p= 0.046, respectively). AA MS patients had lower baseline HCVA (p = 0.02) and worse LCVA per year of disease duration (p= 0.039). Among patients with an acute optic neuritis (AON) history, AA had greater loss of HCVA than CA patients (p = 0.012). This multicenter investigation provides objective evidence that AA MS patients exhibit accelerated retinal damage compared to CA MS patients. Self-identified AA ancestry is associated with worse MS-related visual disability, particularly in the context of an AON history, suggesting a more aggressive inflammatory disease course among AA MS patients or a subpopulation therein.
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影响因子：
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作者：
Phillips, PH;Newman, NJ;Lynn, MJ
通讯作者：
Lynn, MJ
影响因子：
11.2
作者：
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通讯作者：
POSER, CM
影响因子：
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影响因子：
9.9
作者：
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Cross, Anne H.
影响因子：
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作者：
Polman CH;Reingold SC;Banwell B;Clanet M;Cohen JA;Filippi M;Fujihara K;Havrdova E;Hutchinson M;Kappos L;Lublin FD;Montalban X;O'Connor P;Sandberg-Wollheim M;Thompson AJ;Waubant E;Weinshenker B;Wolinsky JS
通讯作者：
Wolinsky JS