Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
Br J Ophthalmol. 2011 Nov;95(11):1577-82. doi: 10.1136/bjo.2010.199232. Epub 2011 Jul 23.
To quantify structural and functional degeneration in the retinal nerve fibre layer (RNFL) of patients with multiple sclerosis (MS) over a 2-year time period, and to analyse the effect of prior optic neuritis (ON) as well as the duration and incidence of MS relapses.
166 MS patients and 120 healthy controls underwent assessment of visual acuity and colour vision, visual field examination, optical coherence tomography, scanning laser polarimetry and visual evoked potentials (VEPs). All subjects were re-evaluated after a period of 12 and 24 months.
Changes in the optic nerve were detected by structural measurements but not by functional assessments. Changes registered in MS patients were greater than changes in healthy controls (p<0.05). Eyes with previous ON showed a greater reduction of parameters in the baseline evaluation, but RNFL atrophy was not significantly greater in the longitudinal study. Patients with MS relapses showed a greater reduction of RNFL thickness and VEP amplitude compared with non-relapsing cases. Patients with and without treatment showed similar measurement reduction, but the non-treated group had a significantly higher increase in Expanded Disability Status Scale (p=0.029).
MS causes progressive axonal loss in the optic nerve, regardless of a history of ON. This ganglion cell atrophy occurs in all eyes but is more marked in MS eyes than in healthy eyes.
在两年的时间内定量多发性硬化症（MS）患者的视网膜神经纤维层（RNFL）的结构和功能退化，并分析既往视神经炎（ON）以及 MS 复发的持续时间和发生率的影响。
166 名 MS 患者和 120 名健康对照者接受了视力和色觉评估、视野检查、光学相干断层扫描、扫描激光偏振测量和视觉诱发电位（VEPs）检查。所有患者在 12 个月和 24 个月后进行了重新评估。
结构测量检测到视神经的变化，但功能评估没有。MS 患者的变化大于健康对照组（p<0.05）。既往有 ON 的眼在基线评估中显示出更大的参数降低，但在纵向研究中，RNFL 萎缩并不明显更大。与非复发病例相比，MS 复发患者的 RNFL 厚度和 VEP 振幅降低更为明显。有和没有治疗的患者的测量值降低相似，但未治疗组的扩展残疾状况量表（EDSS）增加显著更高（p=0.029）。
MS 导致视神经的进行性轴突丢失，无论是否有 ON 病史。这种神经节细胞萎缩发生在所有眼中，但在 MS 眼中比在健康眼中更为明显。
