Differences in retinal nerve fiber layer atrophy between multiple sclerosis subtypes
Differences in retinal nerve fiber layer atrophy between multiple sclerosis subtypes
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DOI:
10.1016/j.jns.2009.02.354
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发表时间:
2009-06-15
影响因子:
4.4
通讯作者:
DeMeulemeester, Christine
中科院分区:
文献类型:
--
作者:
Costello, Fiona;Hodge, William;DeMeulemeester, Christine
Objectives: To determine whether retinal nerve fiber layer (RNFL) atrophy in the afferent visual pathway may complement existing tools used to describe and characterize differences across MS subtypes.Methods: Optical coherence tomography-measured RNFL values were compared over two years in 35 patients (70 eyes) with optic neuritis (ON) as a clinically isolated syndrome (CIS): 39 patients (78 eyes) with relapsing remitting MS (RRMS); and 7 patients (14 eyes) with secondary progressive MS (SPMS).Results: RNFL comparisons involving eyes without ON yielded greater differences between MS subtypes than ON-affected eyes. Overall RNFL values in non-affected eyes were reduced in SPMS patients (83.4 W), relative to CIS (101.2 mu m) (p = 0.0009), and RRMS patients (103.7 mu m) (p = 0.001); and temporal RNFL atrophy was greater in RRMS (64.4 mu m) eyes as compared to CIS eyes (73.2 mu m) (p = 0.02). In ON-affected eyes, RNFL atrophy was greater in SPMS patients (39.5 mu m) than CIS patients (58.1 mu m) (p = 0.03), and in RRMS patients (48.2 mu m) relative to CIS patients (p=0.05). RNFL values did not change significantly for any MS subtype during the two-year duration of the study.Interpretation: RNFL thickness may represent a structural marker, which can help distinguish MS subtypes, because the extent of atrophy is commensurate with disease progression. RNFL comparisons between non-affected eyes revealed greater differences between CIS, RRMS, and SPMS patients relative to ON-affected eyes, because the impact of prior ON may supplant the effects of disease subtype. (C) 2009 Elsevier B.V. All rights reserved.