Costello Fiona, Coupland Stuart, Hodge William, Lorello Gianni R, Koroluk Jeannie, Pan Y Irene, Freedman Mark S, Zackon David H, Kardon Randy H
Division of Neurology, Ottawa, Ontario Canada.
Ann Neurol. 2006 Jun;59(6):963-9. doi: 10.1002/ana.20851.
To determine to what degree changes in retinal nerve fiber layer (RNFL) thickness after optic neuritis (ON) correlate with either visual recovery or impairment.
ON can cause visible defects within the RNFL, which can be quantified using optical coherence tomography (OCT). It may be possible to predict visual recovery by measuring RNFL loss after ON. Fifty-four patients underwent repeated evaluations with optical coherence tomography and standardized ophthalmic testing after ON. Regression analyses were used to determine the relationship between RNFL thickness and visual function.
Thinning of the RNFL was seen in the majority of patients (74%), and it tended to occur within 3 to 6 months of ON. The average RNFL value was thinner (p<0.0001) in the affected (78 microm) compared with the unaffected eye (100 microm). Patients with incomplete visual recovery demonstrated greater RNFL loss after ON. Regression analyses demonstrated a threshold of RNFL thickness (75 microm), below which RNFL measurements predicted persistent visual dysfunction.
Determination of RNFL thickness may predict visual recovery after ON, and lower RNFL values correlate with impaired visual function. Optical coherence tomography may have a potential role as a surrogate marker for axonal integrity within the optic nerve among patients with ON.
确定视神经炎（ON）后视网膜神经纤维层（RNFL）厚度的变化与视力恢复或损害的相关程度。
ON可导致RNFL出现可见缺损，可使用光学相干断层扫描（OCT）对其进行量化。通过测量ON后的RNFL损失，有可能预测视力恢复情况。54例患者在ON后接受了光学相干断层扫描和标准化眼科检查的重复评估。采用回归分析来确定RNFL厚度与视觉功能之间的关系。
大多数患者（74%）出现RNFL变薄，且往往发生在ON后的3至6个月内。患眼的平均RNFL值（78微米）比未患眼（100微米）更薄（p<0.0001）。视力恢复不完全的患者在ON后RNFL损失更大。回归分析显示RNFL厚度阈值为75微米，低于该值时RNFL测量结果可预测持续性视觉功能障碍。
测定RNFL厚度可能预测ON后的视力恢复情况，较低的RNFL值与视觉功能受损相关。光学相干断层扫描可能在ON患者中作为视神经轴突完整性的替代标志物发挥潜在作用。
