Alterations in the retinal vasculature occur in multiple sclerosis and exhibit novel correlations with disability and visual function measures
Alterations in the retinal vasculature occur in multiple sclerosis and exhibit novel correlations with disability and visual function measures
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DOI：
10.1177/1352458519845116
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发表时间：
2020-06-01
影响因子：
5.8
通讯作者：
Saidha, Shiv
中科院分区：
文献类型：
--
作者：
Murphy, Olwen C.;Kwakyi, Ohemaa;Saidha, Shiv
背景：多发性硬化（MS）患者的视网膜血管可能发生改变，可能作为疾病过程的生物标志物。目的：比较MS（PwMS）和健康对照（HC）人群的视网膜血管丛密度，并检查与视觉功能和整体残疾的相关性。方法：对111例（201眼）PwMS和50例（97眼）HCs进行光学相干断层扫描血管造影（OCTA）。定量黄斑浅层血管丛（SVP）和深层血管丛（DVP）密度，并根据伪影评级方案排除质量差的图像。结果如下：平均SVP密度为24.1%（SD = 5.5）MS眼（非视神经炎（ON）眼为26.0%（SD = 4.7），（SD = 5.5）ON眼，p < 0.001），相比之下，HC眼（SD = 3.3）（所有MS眼和多发性硬化症视神经炎（MSON）眼与HC眼相比p < 0.001，MS非ON眼与HC眼相比p = 0.03）。两组间DVP密度无差异。在PwMS中，较低的SVP密度与较高的残疾水平（扩展残疾状态量表（EDSS）：R-2 = 0.26，p = 0.004;多发性硬化症功能复合量表（MSFC）：R-2 = 0.27，p = 0.03）和较低的字母敏锐度评分（100%对比度：R-2 = 0.29; 2.5%对比度：R-2 = 0.40; 1.25%对比度：R-2 = 0.31;所有P < 0.001）相关。结论：通过OCTA测量的视网膜SVP密度在MS眼中降低，并与视功能、EDSS和MSFC评分相关。
Background: The retinal vasculature may be altered in multiple sclerosis (MS), potentially acting as a biomarker of disease processes. Objective: To compare retinal vascular plexus densities in people with MS (PwMS) and healthy controls (HCs), and examine correlations with visual function and global disability. Methods: In this cross-sectional study, 111 PwMS (201 eyes) and 50 HCs (97 eyes) underwent optical coherence tomography angiography (OCTA). Macular superficial vascular plexus (SVP) and deep vascular plexus (DVP) densities were quantified, and poor quality images were excluded according to an artifact-rating protocol. Results: Mean SVP density was 24.1% (SD = 5.5) in MS eyes (26.0% (SD = 4.7) in non-optic neuritis (ON) eyes vs. 21.7% (SD = 5.5) in ON eyes,p < 0.001), as compared to 29.2% (SD = 3.3) in HC eyes (p < 0.001 for all MS eyes and multiple sclerosis optic neuritis (MSON) eyes vs. HC eyes,p = 0.03 for MS non-ON eyes vs. HC eyes). DVP density did not differ between groups. In PwMS, lower SVP density was associated with higher levels of disability (expanded disability status scale (EDSS):R-2 = 0.26,p = 0.004; multiple sclerosis functional composite (MSFC):R-2 = 0.27,p = 0.03) and lower letter acuity scores (100% contrast:R-2 = 0.29; 2.5% contrast:R-2 = 0.40; 1.25% contrast:R-2 = 0.31;p < 0.001 for all). Conclusions: Retinal SVP density measured by OCTA is reduced across MS eyes, and correlates with visual function, EDSS, and MSFC scores.