Neurology. 2013 Jan 8;80(2):128-9. doi: 10.1212/WNL.0b013e31827ccf4a. Epub 2012 Dec 5.
In the evaluation of patients with multiple sclerosis (MS), optical coherence tomography (OCT) is gaining traction as a tool to assess thinning of the retinal nerve fiber layer (RNFL) and, more recently, for looking at total macular volume (TMV) thickness, with both measures used as potential biomarkers for progression of disease. In medicine, it is not uncommon for structural changes to be presumed to reflect a certain physiologic process, when in fact, an alternative mechanism is at play. Fingolimod (FTY-720) is a sphingosine-1-phosphate receptor modulator that is an approved oral treatment for MS and leads to reduced cortical volume loss in patients with MS.(1) Similar to other disease-modifying agents, it is likely to be judged in part by its ability to slow loss of the RNFL and TMV. But would such a judgment be valid?
在多发性硬化症（MS）患者的评估中，光学相干断层扫描（OCT）作为评估视网膜神经纤维层（RNFL）变薄的工具越来越受到关注，最近也用于观察全黄斑体积（TMV）厚度，这两种测量方法都被用作疾病进展的潜在生物标志物。在医学领域，结构变化被认为反映了某种生理过程，而实际上可能存在替代机制，这种情况并不少见。芬戈莫德（FTY-720）是一种鞘氨醇-1-磷酸受体调节剂，已被批准用于治疗多发性硬化症，可减少多发性硬化症患者的皮质体积损失。(1)与其他疾病修正药物类似，它可能部分通过减缓 RNFL 和 TMV 的损失来进行评估。但这样的判断是否合理呢？
