Center for Neuroimmunology, Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Spain.
Mult Scler. 2012 Jul;18(7):991-9. doi: 10.1177/1352458511431972. Epub 2012 Jan 30.
Multiple Sclerosis (MS) frequently causes injury to the anterior visual pathway (AVP), impairing quality of life due to visual dysfunction. Development of biomarkers in MS is a high priority and both low-contrast visual acuity (LCVA) and time-domain optical coherence tomography (TD-OCT) have been proposed as candidates for this purpose. We sought to assess whether psychophysical assessments of color vision are similarly correlated with structural measures of AVP injury, and therefore augment measures of visual disability in MS.
We studied the association between high-contrast visual acuity (HCVA), LCVA, color vision (Hardy-Rand-Rittler plates (HRR) and Lanthony D15 tests) and OCT, using both high-resolution spectral-domain OCT (SD-OCT; Spectralis, Heidelberg Engineering, Germany) and TD-OCT (Stratus, Carl Zeiss, US) in a cohort of 213 MS patients (52 with previous optic neuritis) and 47 matched controls in a cross-sectional study.
We found that MS patients have impairments in HCVA and LCVA (p < 0.001) but that they suffer from even more profound abnormalities in color discrimination (p < 0.0001). We found strong correlation between color vision and SD-OCT measures of retinal nerve fiber layer (RNFL) thickness (average RNFL, r = 0.594, p < 0.001) and papillomacular bundle thickness (r = -0.565, p < 0.001). The correlation between OCT scores and functional visual impairments of all types was much stronger for SD-OCT than for TD-OCT.
Our results indicate that color vision is highly correlated with these OCT scores when compared with traditional measures of visual acuity. Also we found that SD-OCT is superior to TD-OCT for detecting anterior visual pathway damage in MS. This makes both color-visual measures and SD-OCT strong candidate biomarkers of disease progression.
多发性硬化症（MS）常导致前视觉通路（AVP）损伤，导致视觉功能障碍，从而降低生活质量。MS 生物标志物的开发是当务之急，低对比视力（LCVA）和时域光相干断层扫描（TD-OCT）都被提议作为该目的的候选者。我们旨在评估色觉的心理物理评估是否与 AVP 损伤的结构测量同样相关，从而增强 MS 中的视觉残疾测量。
我们在横断面研究中，研究了 213 例 MS 患者（52 例有既往视神经炎）和 47 例匹配对照者的高对比度视力（HCVA）、LCVA、色觉（Hardy-Rand-Rittler 板（HRR）和 Lanthony D15 测试）与 OCT 之间的关联。我们使用高分辨率光谱域 OCT（SD-OCT；Spectralis，德国海德堡工程公司）和 TD-OCT（Stratus，美国卡尔蔡司公司）。
我们发现 MS 患者的 HCVA 和 LCVA 受损（p<0.001），但他们的色觉辨别力（p<0.0001）受损更严重。我们发现色觉与 SD-OCT 视网膜神经纤维层（RNFL）厚度平均 RNFL（r=0.594，p<0.001）和视乳头黄斑束厚度（r=-0.565，p<0.001）的测量值之间存在很强的相关性。与传统视力测量相比，SD-OCT 评分与各种类型的功能视觉损伤之间的相关性要强得多。
与传统的视力测量相比，我们的结果表明，色觉与这些 OCT 评分高度相关。此外，我们发现 SD-OCT 比 TD-OCT 更能检测 MS 中的前视觉通路损伤。这使得色觉测量和 SD-OCT 都成为疾病进展的强有力的候选生物标志物。
