Longitudinal follow-up of vision in a neuromyelitis optica cohort
Longitudinal follow-up of vision in a neuromyelitis optica cohort
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DOI：
10.1177/1352458513476562
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发表时间：
2013-09-01
影响因子：
5.8
通讯作者：
De Seze, J.
中科院分区：
文献类型：
--
作者：
Bouyon, M.;Collongues, N.;De Seze, J.
背景：视神经肌炎（NMO）是一种与视神经炎和肌萎缩相关的炎症性疾病。最近，一些研究表明，光学相干断层扫描（OCT）可能是一种有趣的方法，用于评估疾病的严重程度;然而，迄今为止，还没有研究与纵向随访的视觉功能在NMO。本研究的目的是评估光学相干断层扫描的能力，以评估视功能障碍的进展，在NMO。患者和方法：一组30例NMO患者（因此，60只眼睛），包括20名女性和10名男性，平均年龄为43.7 +/- 12.3岁，前瞻性地进行临床评价和全面的神经眼科检查，包括：视力（VA）、眼底镜检查、视觉诱发电位（VEP）、视野（VF）和光学相干断层扫描（OCT）。所有患者均在基线（平均病程6.1年）和平均随访18个月（范围：12-36个月）后进行测试。结果：两次评估时的平均VA相似（0.77 +/- 0.36 vs 0.77 +/- 0.35）。平均VF缺损略有下降，但差异不显著（-5.9 +/- 1.3 dB vs-5.3 +/- 1.3 dB）。相比之下，OCT上观察到的平均视网膜厚度从87.4 +/- 23.3 μ m降至79.7 +/- 22.4 μ m（p = 0.006）。这些改变仅在有视神经炎病史或近期病史的眼睛中观察到（-15.1 μ m; p < 0.001），而在没有任何视神经炎病史的眼睛中未观察到（-2.4 μ m;不显著）。此外，他们发生独立的复发（n = 13），特别是视神经炎发作的发生，但是，视神经炎发作的数量是低的（n = 5）。结论：OCT似乎是一个更敏感的测试比VA或VF监测眼功能在NMO，它似乎是有帮助的检测临床下发作的患者与过去的视神经炎病史。我们的研究结果表明，这种容易执行的技术应用于后续的NMO，但补充研究是必要的，以确认其利益在个人层面上。
Background: Neuromyelitis optica (NMO) is an inflammatory disease associated with optic neuritis and myelitis. Recently, several studies showed that optical coherence tomography (OCT) could be an interesting method for the evaluation of disease severity; however, to date there are no studies with a longitudinal follow-up of visual function in NMO. The aim of this study was to assess the ability of OCT to evaluate the progression of visual dysfunction in NMO.Patients and methods: A group of 30 NMO patients (thus, 60 eyes), comprised of 20 women and 10 men with a mean age of 43.7 +/- 12.3 years, were prospectively evaluated clinically and by a whole neuro-ophthalmological work-up, including: visual acuity (VA), fundoscopy, visual evoked potential (VEP), visual field (VF) and optical coherence tomography (OCT). All patients were tested at baseline (after a mean disease duration of 6.1 years) and after a mean time of follow-up of 18 months (range: 12-36 months).Results: Mean VA was similar at the two evaluation times (0.77 +/- 0.36 versus 0.77 +/- 0.35). The mean VF defect decreased slightly, but the difference was not significant (-5.9 +/- 1.3 dB versus -5.3 +/- 1.3 dB). In contrast, the mean retinal thickness seen on OCT decreased from 87.4 +/- 23.3 mu m to 79.7 +/- 22.4 mu m (p = 0.006). These modifications were only observed in eyes with a past or a recent history of optic neuritis (-15.1 mu m; p < 0.001) and not in eyes without any history of optic neuritis (-2.4 mu m; not significant). Also, they occurred independently of the occurrence of relapses (n = 13) and especially optic neuritis episodes; however, the number of optic neuritis episodes was low (n = 5).Conclusion: OCT seems to be a more sensitive test than VA or VF for monitoring ophthalmological function in NMO and it seems to be helpful for the detection of infra-clinical episodes in patients with a past history of optic neuritis. Our results suggest that this easily performed technique should be used in the follow-up of NMO, but complementary studies are warranted to confirm its interest at an individual level.