The temporal evolution of structural and functional measures after acute optic neuritis
The temporal evolution of structural and functional measures after acute optic neuritis
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DOI：
10.1136/jnnp-2014-309704
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发表时间：
2015-12-01
影响因子：
11
通讯作者：
Kardon, Randy
中科院分区：
文献类型：
--
作者：
Costello, Fiona;Pan, Y. Irene;Kardon, Randy
背景在这个前瞻性的病例系列中，我们的目的是观察急性视神经炎（ON）患者传入视觉通路的功能和结构指标的时间演变。在基线、症状发作后3个月、6个月和12个月进行光谱域光学相干断层扫描、早期治疗糖尿病视网膜病变研究最小分辨角（LogMAR）视力对数和Humphrey视野中心30-2阈值（SITA策略）的测试。主要的观察指标是ON眼的平均视乳头周围视网膜神经纤维层（RNFL）厚度。次要结局包括平均神经节细胞层（GCL）厚度、LogMAR视力和Humphrey视野检查法测量的视野平均偏差（VFMD）。生存分析进行Kaplan-Meier曲线和模型中的变量进行了测试，使用logrank test.Results超过12个月，RNFL和GCL值进行性下降，在ON的眼睛，眼间差异在所有时间点有显著性差异。当功能恢复定义为ON眼的VFMD优于-5.00 dB时，整个队列的平均恢复时间为3个月（生存率为48%，SE= 0.09，95% CI 0.30至0.64）。有显着差异的累积恢复时，性别之间的比较：症状发作后3个月有较高的百分比累积恢复女性（75%）与男性（25%）patients.Conclusions结构和功能的措施，随着时间的推移，在患者ON。
Background In this prospective case series, we aimed to characterise the temporal evolution of functional and structural measures in the afferent visual pathway of patients with acute optic neuritis (ON).Methods Fifty patients with ON were followed over 12 months. Testing with spectral-domain optical coherence tomography, Early Treatment Diabetic Retinopathy Study logarithm of the minimum angle of resolution (LogMAR) visual acuity and Humphrey perimetry central 30-2 threshold (SITA strategy) was performed at baseline, 3, 6 and 12 months after symptom onset. The main outcome measure was mean peripapillary retinal nerve fibre layer (RNFL) thickness in ON eyes. Secondary outcomes included mean ganglion cell layer (GCL) thickness, LogMAR visual acuity, and Humphrey perimetry measured visual field mean deviation (VFMD). Survival analyses were performed to Kaplan-Meier curves and variables in the models were tested using the log-rank test.Results Over 12 months, RNFL and GCL values progressively declined in ON eyes, and intereye differences were significantly different across all time points. When functional recovery was defined as a VFMD better than -5.00 dB in ON eyes, the mean recovery time for the entire cohort was 3 months (survival was 48%, SE= 0.09, 95% CI 0.30 to 0.64). There were significant differences in cumulative recovery when comparisons were made between genders: 3 months after symptom onset there was a higher percentage cumulative recovery for female (75%) versus male (25%) patients.Conclusions Structural and functional measures evolve over time in patients with ON. There may be sex-specific differences in recovery after an acute ON event.