Trip S Anand, Schlottmann Patricio G, Jones Stephen J, Altmann Daniel R, Garway-Heath David F, Thompson Alan J, Plant Gordon T, Miller David H
NMR Research Unit, Department of Neuroinflammation, Brain Injury and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom.
Ann Neurol. 2005 Sep;58(3):383-91. doi: 10.1002/ana.20575.
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.
轴突损失被认为是多发性硬化症复发后导致持续残疾的一个可能原因；因此，需要针对轴突损失的非侵入性体内标志物。我们将视神经炎作为多发性硬化症复发的模型，利用光学相干断层扫描技术来量化视网膜神经纤维层（RNFL）的轴突损失以及黄斑区继发性视网膜神经节细胞的损失。我们研究了25例既往有单次视神经炎发作史的患者，这些患者存在招募偏倚，倾向于那些恢复不完全的患者，同时纳入了15名对照受试者。进行了RNFL厚度和黄斑体积的光学相干断层扫描测量、定量视觉测试以及电生理检查。与对照眼和临床上未受影响的对侧眼相比，受影响患者眼的RNFL厚度和黄斑体积有极显著降低（p < 0.001）。RNFL厚度与视力、视野、色觉和视觉诱发电位振幅之间存在显著相关性。本研究表明，视神经炎后RNFL和黄斑区分别出现了与轴突损失和视网膜神经节细胞损失相关的功能改变。这种非侵入性的RNFL成像技术可用于旨在保护视神经免受轴突损失的实验性治疗试验。
