Departamento de Neurologia e Neurocirurgia (DBB, ABF, EMLdO) and Departamento de Oftalmologia (ASdC, FFG, IMT), Universidade Federal de São Paulo, São Paulo, Brazil.
J Neuroophthalmol. 2013 Sep;33(3):220-4. doi: 10.1097/WNO.0b013e31829f39f1.
To compare the retinal nerve fiber layer (RNFL) in eyes of patients with relapsing remitting multiple sclerosis (RRMS), neuromyelitis optica (NMO) and chronic relapsing inflammatory optic neuritis (CRION).
Evaluation of 62 patients with RRMS, NMO, and CRION in a cross-sectional study with spectral domain optical coherence tomography.
A total of 124 eyes were evaluated (96 RRMS, 18 NMO, and 10 CRION). Frequency of optic neuritis for each disease was: 34% for RRMS, 84% for NMO, and 100% for CRION. Visual acuity and RNFL thickness were significantly worse in NMO and CRION eyes than in RRMS, but there were no differences between NMO and CRION eyes. A RNFL of 41 μm was 100% specific for optic neuritis associated with NMO and CRION when compared to RRMS.
This study established RNFL values to differentiate optic neuritis of RRMS from NMO and CRION. Although similarities observed between NMO and CRION eyes might suggest that they are within the same disease spectrum, it is still recommended that these 2 conditions be differentiated on clinical grounds. Optical coherence tomography serves as an additional diagnostic tool and can be used to monitor disease progression.
比较复发缓解型多发性硬化症（RRMS）、视神经脊髓炎（NMO）和慢性复发性炎症性视神经炎（CRION）患者的视网膜神经纤维层（RNFL）。
对横断面研究中的 62 例 RRMS、NMO 和 CRION 患者进行频域光相干断层扫描评估。
共评估了 124 只眼（96 只 RRMS、18 只 NMO 和 10 只 CRION）。每种疾病的视神经炎发生率为：RRMS 为 34%，NMO 为 84%，CRION 为 100%。NMO 和 CRION 眼的视力和 RNFL 厚度明显差于 RRMS，但 NMO 和 CRION 眼之间无差异。与 RRMS 相比，41μm 的 RNFL 对 NMO 和 CRION 相关的视神经炎具有 100%的特异性。
本研究建立了区分 RRMS 与 NMO 和 CRION 视神经炎的 RNFL 值。尽管 NMO 和 CRION 眼之间观察到的相似性可能表明它们处于同一疾病谱内，但仍建议根据临床标准区分这两种情况。光学相干断层扫描作为一种额外的诊断工具，可用于监测疾病进展。
