Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography.
Evaluation of inner retinal layers in patients with multiple sclerosis or neuromyelitis optica using optical coherence tomography.
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DOI：
10.1016/j.ophtha.2012.07.066
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发表时间：
2013-02
期刊：
影响因子：
13.7
通讯作者：
Monteiro ML
中科院分区：
文献类型：
--
作者：
Fernandes DB;Raza AS;Nogueira RG;Wang D;Callegaro D;Hood DC;Monteiro ML
目的：应用频域光学相干断层扫描(FD-OCT)技术评价脱髓鞘疾病患者黄斑视网膜内层厚度。对176名受试者301只眼进行了横断面研究。受试者分为5组：对照组、视神经脊髓炎(NMO)组、纵向广泛性横贯性脊髓炎(LETM)组、有视神经炎病史的多发性硬化(MS-ON)组和无视神经炎病史(MS-ON)的多发性硬化症(MS-ON)组。使用自动算法对黄斑FD-OCT立方体扫描的各个层进行分割，然后手动校正。在每次扫描中，我们测定了视网膜神经纤维层(RNFL)、视网膜神经节细胞与内网状层结合的厚度(RGCL+)和内核层(INL)的厚度。黄斑视网膜神经纤维层厚度、视网膜神经纤维层厚度和视网膜神经纤维层厚度所有患者组的视网膜神经纤维层均较对照组明显变薄(p≤0.0 1)。NMO组、MS-ON组和MS非ON组的黄斑RGCL+厚度明显小于对照组(P<；3组均为0.001)。正常组(p=0.003)和低渗出组(p=0.006)患者中膜厚度显著高于对照组，而MS-On和MS Non-On患者则无显著差异。虽然NMO组和MS-ON组之间的RNFL和RGCL+无显著差异，但NMO组的INL明显厚于MS-ON组(p=0.02)。黄斑RNFL和RGCL+在MS和NMO患者中显示轴突和神经丢失，无论是否有ON。此外，NMO和LETM患者的INL增厚，对这一层的研究可能有助于鉴别NMO和MS。
To evaluate the thickness of the inner retinal layers in the macula using frequency domain-optical coherence tomography (fd-OCT) in patients with demyelinating diseases. Cross sectional study 301 eyes of 176 subjects were evaluated. Subjects were divided in 5 different groups: controls, neuromyelitis optica (NMO), longitudinally extensive transverse myelitis (LETM), multiple sclerosis with (MS-ON) and without (MS non-ON) history of optic neuritis, respectively. The individual layers from macular fd-OCT cube scans were segmented with an automated algorithm, and then manually hand-corrected. For each scan, we determined the thickness of the retinal nerve fiber layer (RNFL), the combined retinal ganglion cell and inner plexiform layers (RGCL+), and the inner nuclear layer (INL). Macular RNFL, RGCL+ and INL thickness The RNFL was significantly thinner than controls for all patient groups (p≤0.01). Macular RGCL+ thickness was significantly thinner than controls for the NMO, MS-ON and MS non-ON (p<0.001 for the 3 groups). The INL thickness was significantly thicker than controls for the NMO (p=0.003) and LETM (p=0.006) patients but not for MS-ON or MS non-ON. While the RNFL and RGCL+ were not significantly different between the NMO and MS-ON groups, the NMO patients had a significantly thicker INL than the MS-ON (p=0.02) patients. Macular RNFL and RGCL+ demonstrate axonal and neural loss in MS, either with or without ON, and in NMO patients. In addition, the INL thickening occurs in NMO and LETM patients and study of this layer may hold promise for differentiating between NMO and MS.
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