Stamenković Miroslav, Obradović Dragana
University Medical Center Zvezdara, Eye Clinic, Belgrade, Serbia.
Vojnosanit Pregl. 2011 Jul;68(7):544-9. doi: 10.2298/vsp1107544s.
BACKGROUND/AIM: Multiple sclerosis (MS) is an immune-mediated disorder of the central nervous system (CNS), characterized by inflammation, demyelination and axonal loss. Retinal periphlebitis (RP) is often present in MS patients with similar evolution and histopathological changes as MS lesions. The aim of this study was to analyze the presence of RP in MS patients during different clinical phases, and its connection with impairment of blood-brain barrier.
The study included 45 patients (26 females and 19 males) with MS. Their average age was 33.2 +/- 8.1 years. There were 28 patients with relapsing-remitting (RR) form, 7 with primary progresive (PP) and 10 with secondary progressive (SP) form of MS. There were 27 patients in the relapse and 18 patients in the remission phase. The average MS duration was 7.48 +/- 1.3 years. Ophthalmological, neurological and MRI examination were performed in all the patients, as well as cerebrospinal fluid sampling. Albumin ratio and IgG index were calculated in all the patients.
There were 9 patients with RP, and 36 without it. MS duration was significantly longer in the RP group. RP was much more common in the progressive form and was not present in the remission phase of MS. Albumin ratio values were increased in the group with RP. IgG index and IgG synthesis according to Tourtellotte formula, were statistically higher in the group of patients with RP. The values of visual evoked potentials (VEP's) latency were significantly higher in the group of patients with RP.
The presence of RP is a reliable indicator of MS activity and might be considered as a parameter for monitoring the disease activity and effects of the treatment.
背景/目的：多发性硬化症（MS）是一种中枢神经系统（CNS）的免疫介导性疾病，其特征为炎症、脱髓鞘和轴突损失。视网膜静脉周围炎（RP）常出现在MS患者中，其演变和组织病理学变化与MS病变相似。本研究的目的是分析不同临床阶段MS患者中RP的存在情况及其与血脑屏障损害的关系。
该研究纳入了45例MS患者（26例女性和19例男性）。他们的平均年龄为33.2±8.1岁。其中28例为复发缓解型（RR）MS，7例为原发进展型（PP），10例为继发进展型（SP）MS。27例患者处于复发期，18例处于缓解期。MS的平均病程为7.48±1.3年。对所有患者进行了眼科、神经科和MRI检查以及脑脊液采样。计算了所有患者的白蛋白比率和IgG指数。
9例患者有RP, 36例没有。RP组的MS病程明显更长。RP在进展型中更为常见，在MS缓解期不存在。有RP的组白蛋白比率值升高。根据Tourtellotte公式，有RP的患者组IgG指数和IgG合成在统计学上更高。有RP的患者组视觉诱发电位（VEP）潜伏期值明显更高。
RP的存在是MS活动的可靠指标，可被视为监测疾病活动和治疗效果的一个参数。
