Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
PLoS One. 2012;7(1):e30922. doi: 10.1371/journal.pone.0030922. Epub 2012 Jan 26.
To evaluate macular morphology in the eyes of patients with multiple sclerosis (MS) with or without optic neuritis (ON) in previous history.
Optical coherence tomography (OCT) examination was performed in thirty-nine patients with MS and in thirty-three healthy subjects. The raw macular OCT data were processed using OCTRIMA software. The circumpapillary retinal nerve fiber layer (RNFL) thickness and the weighted mean thickness of the total retina and 6 intraretinal layers were obtained for each eye. The eyes of MS patients were divided into a group of 39 ON-affected eyes, and into a group of 34 eyes with no history of ON for the statistical analyses. Receiver operating characteristic (ROC) curves were constructed to determine which parameter can discriminate best between the non-affected group and controls.
The circumpapillary RNFL thickness was significantly decreased in the non-affected eyes compared to controls group only in the temporal quadrant (p = 0.001) while it was decreased in the affected eyes of the MS patients in all quadrants compared to the non-affected eyes (p<0.05 in each comparison). The thickness of the total retina, RNFL, ganglion cell layer and inner plexiform layer complex (GCL+IPL) and ganglion cell complex (GCC, comprising the RNFL and GCL+IPL) in the macula was significantly decreased in the non-affected eyes compared to controls (p<0.05 for each comparison) and in the ON-affected eyes compared to the non-affected eyes (p<0.001 for each comparison). The largest area under the ROC curve (0.892) was obtained for the weighted mean thickness of the GCC. The EDSS score showed the strongest correlation with the GCL+IPL and GCC thickness (p = 0.007, r = 0.43 for both variables).
Thinning of the inner retinal layers is present in eyes of MS patients regardless of previous ON. Macular OCT image segmentation might provide a better insight into the pathology of neuronal loss and could therefore play an important role in the diagnosis and follow-up of patients with MS.
评估既往有或无视神经炎（ON）病史的多发性硬化症（MS）患者的黄斑形态。
对 39 例 MS 患者和 33 例健康对照者进行光学相干断层扫描（OCT）检查。使用 OCTRIMA 软件处理原始黄斑 OCT 数据。获得每只眼的环周视网膜神经纤维层（RNFL）厚度和总视网膜及 6 个内视网膜层的加权平均厚度。将 MS 患者的眼分为 39 只 ON 受累眼组和 34 只无 ON 病史眼组进行统计分析。构建受试者工作特征（ROC）曲线以确定哪个参数可以最好地区分非受累组和对照组。
与对照组相比，非受累眼中的环周 RNFL 厚度在颞象限显著降低（p=0.001），而 MS 患者受累眼中的环周 RNFL 厚度在所有象限均低于非受累眼（每比较均 p<0.05）。与对照组相比，非受累眼中的总视网膜、RNFL、节细胞层和内丛状层复合体（GCL+IPL）以及节细胞复合体（GCC，包括 RNFL 和 GCL+IPL）厚度显著降低（每比较均 p<0.05），与非受累眼相比，ON 受累眼中的厚度也显著降低（每比较均 p<0.001）。ROC 曲线下面积最大（0.892）的为 GCC 的加权平均厚度。EDSS 评分与 GCL+IPL 和 GCC 厚度相关性最强（p=0.007，r=0.43，两者均有）。
无论既往是否有 ON，MS 患者的眼内视网膜层均变薄。黄斑 OCT 图像分割可能更深入地了解神经元丢失的病理，因此在 MS 患者的诊断和随访中可能发挥重要作用。
