Ratchford J N, Quigg M E, Conger A, Frohman T, Frohman E, Balcer L J, Calabresi P A, Kerr D A
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Neurology. 2009 Jul 28;73(4):302-8. doi: 10.1212/WNL.0b013e3181af78b8.
To evaluate the retinal nerve fiber layer (RNFL) thickness and macular volume in neuromyelitis optica (NMO) spectrum patients using optical coherence tomography (OCT).
OCT can quantify damage to retinal ganglion cell axons and can identify abnormalities in multiple sclerosis and optic neuritis (ON) eyes. OCT may also be useful in the evaluation of patients with NMO.
OCT and visual function testing were performed in 26 NMO spectrum patients with a history of ON, 17 patients with isolated longitudinally extensive transverse myelitis (LETM) without ON, 378 patients with relapsing-remitting multiple sclerosis (RRMS), and 77 healthy controls at 2 centers.
Substantial RNFL thinning was seen in NMO ON eyes (63.6 microm) relative to both RRMS ON eyes (88.3 microm, p < 0.0001) and control eyes (102.4 microm, p < 0.0001). A first episode of ON was estimated to cause 24 microm more loss of RNFL thickness in NMO than RRMS. Similar results were seen for macular volume. ON also was associated with more severe visual impairment in NMO spectrum patients than in RRMS patients. Eyes in the LETM group and unaffected NMO eyes were not significantly different from controls, though conclusions about these subgroups were limited by small sample sizes.
Optical coherence tomography (OCT) shows more severe retinal damage after optic neuritis (ON) episodes in neuromyelitis optica (NMO) than in relapsing-remitting multiple sclerosis. Identification of substantial retinal nerve fiber layer loss (>15 microm) after ON in a non-multiple sclerosis patient should prompt consideration of an NMO spectrum condition. OCT may be a useful tool for the evaluation of patients with NMO.
使用光学相干断层扫描（OCT）评估视神经脊髓炎（NMO）谱系疾病患者的视网膜神经纤维层（RNFL）厚度和黄斑体积。
OCT可量化视网膜神经节细胞轴突的损伤，并能识别多发性硬化症和视神经炎（ON）患者眼睛的异常情况。OCT在NMO患者的评估中可能也有用。
在2个中心对26例有视神经炎病史的NMO谱系疾病患者、17例无视神经炎的孤立性纵向广泛性横贯性脊髓炎（LETM）患者、378例复发缓解型多发性硬化症（RRMS）患者和77名健康对照者进行了OCT和视觉功能测试。
相对于RRMS的视神经炎患眼（88.3微米，p<0.0001）和对照眼（102.4微米，p<0.0001），NMO的视神经炎患眼中可见明显的RNFL变薄（63.6微米）。据估计，首次视神经炎发作导致NMO患者的RNFL厚度损失比RRMS患者多24微米。黄斑体积也有类似结果。视神经炎在NMO谱系疾病患者中比在RRMS患者中还与更严重的视力损害相关。LETM组的眼睛和未受影响的NMO眼睛与对照眼无显著差异，不过这些亚组的结论因样本量小而受限。
光学相干断层扫描（OCT）显示，视神经脊髓炎（NMO）患者视神经炎（ON）发作后的视网膜损伤比复发缓解型多发性硬化症更严重。在非多发性硬化症患者中，视神经炎发作后若发现视网膜神经纤维层大量丢失（>15微米），应考虑NMO谱系疾病。OCT可能是评估NMO患者的有用工具。
