Forooghian Farzin, Sproule Melanie, Westall Carol, Gordon Lynn, Jirawuthiworavong Guy, Shimazaki Kaori, O'Connor Paul
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Doc Ophthalmol. 2006 Sep;113(2):123-32. doi: 10.1007/s10633-006-9022-0. Epub 2006 Sep 14.
Multiple sclerosis (MS) has been associated with inflammation of the uveal tract, suggesting an immunological link between the uvea and central nervous system (CNS) in this disease. The retina is embryologically derived from the CNS, and it is conceivable that retinal antigens may also be recognized by the immune system in MS. Electroretinographic abnormalities, as well as retinal autoantibodies, have previously been described in MS. We performed this study to further explore the possibility of retinal autoimmunity in MS.
Thirty-four patients with clinically definite MS and thirty-seven healthy controls were recruited. All patients and controls had standard electroretinographic (ERG) testing done, as well as a brightflash ERG protocol to isolate rod photoreceptor function. Patient and control sera were analyzed for the presence of antiretinal antibodies using Western blot techniques.
We found statistically significant differences between MS patients and controls in four ERG parameters. In the MS group, implicit times of the rod-cone b-wave response, cone b-wave response, and rod photoreceptor response were increased. The amplitudes of the photopic oscillatory potentials were reduced in the MS group. Patients with the highest titres of retinal autoantibodies had delayed rod-cone b-wave implicit times and diminished photopic oscillatory potential amplitudes.
We report ERG evidence of retinal dysfunction in patients with MS. We also report the first use of the brightflash ERG protocol in MS, which demonstrated rod photoreceptor dysfunction. Patients with the highest antiretinal antibody titres had abnormal ERG recordings. Retinal autoimmunity is a possible explanation for these observed ERG abnormalities in MS patients.
多发性硬化症（MS）与葡萄膜炎症相关，提示在该疾病中葡萄膜与中枢神经系统（CNS）之间存在免疫联系。视网膜在胚胎学上起源于中枢神经系统，可以想象在MS中视网膜抗原也可能被免疫系统识别。此前已在MS中描述了视网膜电图异常以及视网膜自身抗体。我们进行这项研究以进一步探索MS中视网膜自身免疫的可能性。
招募了34例临床确诊的MS患者和37名健康对照者。所有患者和对照者均进行了标准视网膜电图（ERG）测试，以及用于分离视杆光感受器功能的明闪光ERG检查方案。使用蛋白质印迹技术分析患者和对照者血清中抗视网膜抗体的存在情况。
我们发现MS患者和对照者在四个ERG参数上存在统计学上的显著差异。在MS组中，视杆 - 视锥b波反应、视锥b波反应和视杆光感受器反应的潜伏时间增加。MS组明视振荡电位的振幅降低。视网膜自身抗体滴度最高的患者视杆 - 视锥b波潜伏时间延迟，明视振荡电位振幅减小。
我们报告了MS患者视网膜功能障碍的ERG证据。我们还报告了首次在MS中使用明闪光ERG检查方案，该方案显示视杆光感受器功能障碍。视网膜自身抗体滴度最高的患者ERG记录异常。视网膜自身免疫可能是MS患者中观察到的这些ERG异常的一种解释。
