Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis
Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis
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DOI：
10.1002/ana.20575
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发表时间：
2005-09-01
影响因子：
11.2
通讯作者：
Miller, DH
中科院分区：
文献类型：
--
作者：
Trip, SA;Schlottmann, PG;Miller, DH
轴突丢失被认为是多发性硬化症复发后持续性残疾的可能原因；因此，需要针对轴突丢失的非侵入性体内标志物。我们使用视神经炎作为多发性硬化症复发的模型，通过光学相干断层扫描对黄斑部视网膜神经纤维层(RNFL)轴突丢失和继发性视网膜神经节细胞丢失进行量化。我们研究了25名既往有单次视神经炎发作的患者和15名对照组，这些患者的招募偏向于那些未完全恢复的患者。进行视网膜神经纤维层厚度和黄斑体积的光学相干断层扫描测量、定量视力检查和电生理检查。与对照眼和临床未患眼相比，患眼视网膜神经纤维层厚度和黄斑体积有非常显著的减少(p<；0.001)。视网膜神经纤维层厚度与视力、视野、色觉、视诱发电位波幅呈显著正相关。这项研究证实了视神经炎后RNFL和黄斑的轴突丢失和视网膜神经节细胞丢失的相关功能改变。这种非侵入性的RNFL成像技术可以用于实验治疗，旨在保护视神经免受轴突丢失的影响。
Axonal loss is thought to be a likely cause,of persistent disability after a multiple sclerosis relapse; therefore, noninvasive in vivo markers specific for axonal loss are needed. We used optic neuritis as a model of multiple sclerosis relapse to quantify axonal loss of the retinal nerve fiber layer (RNFL) and secondary retinal ganglion cell loss in the macula with optical coherence tomography. We studied 25 patients who had a previous single episode of optic neuritis with a recruitment bias to those with incomplete recovery and 15 control subjects. Optical coherence tomography measurement of RNFL thickness and macular volume, quantitative visual testing, and electrophysiological examination were performed. There were highly significant reductions (p < 0.001) of RNFL thickness and macular volume in affected patient eyes compared with control eyes and clinically unaffected fellow eyes. There were significant relationships among RNFL thickness and visual acuity, visual field, color vision, and visual-evoked potential amplitude. This study has demonstrated functionally relevant changes indicative of axonal loss and retinal ganglion cell loss in the RNFL and macula, respectively, after optic neuritis. This noninvasive RNFL imaging technique could be used in trials of experimental treatments that aim to protect optic nerves from axonal loss.