Frequent retinal ganglion cell damage after acute optic neuritis
Frequent retinal ganglion cell damage after acute optic neuritis
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DOI：
10.1016/j.msard.2018.04.006
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发表时间：
2018-05-01
影响因子：
4
通讯作者：
Costello, Fiona
中科院分区：
文献类型：
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作者：
Brandt, Alexander U.;Specovius, Svenja;Costello, Fiona
背景资料：要确定神经节细胞损伤的程度后，第一次视神经炎（ON）使用受影响的眼睛和其他眼睛之间的眼间差异，以及这种方法是否能够检测到更多的患者患有神经节细胞损伤比使用绝对values.Methods：34例患者首次单侧ON进行了随访，中位数为413天。患者接受光学相干断层扫描检查，以确定神经节细胞加内丛状层厚度（GCIP）。将神经节细胞损失定量为ON受累眼和对侧眼之间的GCIP差异（GCIP间），并与93名健康对照（HC）的测量值进行比较。视觉功能进行了评估，高对比度视力;和标准的自动周边衍生措施的平均偏差和中央凹threshold.Results：在临床表现后，中位数19天的症状发作，47.1%的患者表现出早期GCIP变薄的ON受影响的眼睛的基础上，间GCIP。在最后一次访视时，与对侧眼相比，急性ON与16.1 +/- 10.0 μ m GCIP变薄相关（p = 3.669e-06）。基于GCIP间，84.9%的ON患者在末次访视时患眼持续GCIP变薄，而使用绝对值时，仅71.0%的患者发生GCIP变薄（p = 0.002076）。仅32.3%的患者有视功能异常。最好的预测GCIP变薄作为衡量ON的严重程度，在最后一次访问是更糟糕的视野平均偏差在临床presentation.Conclusion：眼间GCIP识别显着更多的眼睛遭受损害ON比绝对GCIP，视野或视力丧失。需要有效的干预措施来防止神经节细胞丢失。
Background: To identify the extent of ganglion cell damage after first-time optic neuritis (ON) using the interocular difference between affected and fellow eyes, and whether this approach is able to detect more patients suffering from ganglion cell damage than using absolute values.Methods: Thirty-four patients with first-time unilateral ON were followed for a median 413 days. Patients underwent optical coherence tomography testing to determine ganglion cell plus inner plexiform layer thickness (GCIP). Ganglion cell loss was quantified as GCIP difference between ON-affected and fellow eyes (inter-GCIP) and was compared against measurements from 93 healthy controls (HC). Visual function was assessed with high contrast visual acuity; and standard automated perimetry-derived measures of mean deviation and foveal threshold.Results: At clinical presentation after median 19 days from symptom onset, 47.1% of patients showed early GCIP thinning in the ON-affected eye based on inter-GCIP. At the last visit acute ON was associated with 16.1 +/- 10.0 mu m GCIP thinning compared to fellow eyes (p = 3.669e-06). Based on inter-GCIP, 84.9% of ON patients sustained GCIP thinning in their affected eye at the last visit, whereas using absolute values only 71.0% of patients suffered from GCIP thinning (p = 0.002076). Only 32.3% of these patients had abnormal visual function. The best predictor of GCIP thinning as a measure of ON severity at the last visit was worse visual field mean deviation at clinical presentation.Conclusion: Inter-ocular GCIP identifies significantly more eyes suffering damage from ON than absolute GCIP, visual fields or visual acuity loss. Effective interventional options are needed to prevent ganglion cell loss.