Gundogan Fatih C, Demirkaya Seref, Sobaci Gungor
Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.
Invest Ophthalmol Vis Sci. 2007 Dec;48(12):5773-81. doi: 10.1167/iovs.07-0834.
To assess the structural and functional status of patients with multiple sclerosis (MS) without a history of optic neuritis.
Thirty-nine patients with MS who had reported no visual symptoms before and after the time of MS diagnosis were included. Thirty-eight healthy subjects were included as a control group. Retinal nerve fiber layer (RNFL) thickness was determined by optical coherence tomography. Pattern visual evoked potentials (PVEP), full-field electroretinogram (ERG), and multifocal electroretinogram (mfERG) were performed.
There was a significant reduction (P = 0.011) only in temporal RNFL thickness in patients with MS. P(100) latency was significantly delayed with both 60-min arc checks (P < 0.001) and 15-min arc checks (P < 0.001); however, P(100) amplitude was significantly reduced only in 60-min arc checks (P = 0.026). Rod response b-wave implicit time and standard combined response a- and b-wave implicit times were significantly delayed in patients with MS. Patients with MS with a delayed P(100) latency (21/39; 53.8%) had significantly reduced cone response b-wave amplitude and significantly delayed cone response a- and b-wave implicit times in ERG. mfERG results did not differ between MS and control subjects and between patients with a delayed and a normal P(100) latency. Pearson correlations between RNFL thickness and P(100) amplitude and latency in patients with MS were not significant (P > 0.05).
There is no correlation between RNFL thickness and P(100) response in patients with MS. PVEP seems to be a more reliable biomarker in determining visual pathway involvement in patients with no history of optic neuritis.
评估无视神经炎病史的多发性硬化症(MS)患者的结构和功能状态。
纳入39例在MS诊断前后均未报告视觉症状的MS患者。纳入38名健康受试者作为对照组。通过光学相干断层扫描测定视网膜神经纤维层(RNFL)厚度。进行图形视觉诱发电位(PVEP)、全视野视网膜电图(ERG)和多焦视网膜电图(mfERG)检查。
MS患者仅颞侧RNFL厚度显著降低(P = 0.011)。60分钟弧度检查(P < 0.001)和15分钟弧度检查(P < 0.001)时P(100)潜伏期均显著延迟;然而,仅在60分钟弧度检查时P(100)波幅显著降低(P = 0.026)。MS患者的视杆细胞反应b波潜伏时以及标准联合反应a波和b波潜伏时均显著延迟。P(100)潜伏期延迟的MS患者(21/39;53.8%)在ERG中视锥细胞反应b波波幅显著降低,视锥细胞反应a波和b波潜伏时显著延迟。MS患者与对照组之间以及P(100)潜伏期延迟和正常的患者之间mfERG结果无差异。MS患者中RNFL厚度与P(100)波幅和潜伏期之间的Pearson相关性不显著(P > 0.05)。
MS患者中RNFL厚度与P(100)反应之间无相关性。在确定无视神经炎病史患者的视觉通路受累情况时,PVEP似乎是更可靠的生物标志物。