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光学相干断层扫描在评估继发于多发性硬化症的视神经损伤中的临床研究

[Clinical investigation of optic coherence tomography in evaluating the impairment of optic nerve secondary to multiple sclerosis].

作者信息

Huang Jianfeng, Dai Hong, Zhang Hua, Wang Xiaoxiong, Chen Tong

机构信息

Department of Ophthalmology, Beijing Hospital of Ministry of Health, Beijing 100730, China.

Department of Ophthalmology, Beijing Hospital of Ministry of Health, Beijing 100730, China. Email:

出版信息

Zhonghua Yan Ke Za Zhi. 2014 Dec;50(12):900-5.

Abstract

OBJECTIVE

To evaluate the impairment of optic nerve of different types of multiple sclerosis (MS) by optic coherence tomography (OCT).

METHODS

Cross-sectional study. 52 eyes of 30 patients who diagnosed as MS up to the 2010 Mcdonald criteria were included. 13 eyes of 13 healthy people matched with sex and age were set as the control group. Patients with MS were divided into 3 subgroups based on the history of optic neuritis (ON): 22 eyes of MS patients with the history of ON were in MS-ON group, 16 eyes of MS patients without ON were in MS-NON group and 14 contralateral eyes of MS-ON patients were in MS-ON Contra group. Fourier domain OCT was used to examine. The protocol included macula scanning, retinal nerve fiber layer (RNFL) analysis and ganglion cell complex (GCC) and optic nerve head (ONH) scanning. Visual acuity (VA) and visual field (VF) were also compared. The major measurements were RNFL and GCC thickness. ANOVA was used to compare the overall difference of RNFL and GCC thickness among all the groups. LSD method was used to compare the difference between every two groups.

RESULTS

The thickness of average GCC, superior GCC and inferior GCC of MS-ON group is (80.65 ± 16.03) µm, (81.50 ± 14.56) µm, (79.83 ± 17.65) µm. Compared with the MS-NON group which is (99.65 ± 9.35) µm, (99.26 ± 9.73) µm, (100.06 ± 9.31) µm correspondingly, MS-ON contra group (99.36 ± 8.25) µm, (100.39 ± 8.97) µm, (98.34 ± 7.88) µm correspondingly and the control group (104.87 ± 8.71) µm, (105.36 ± 8.21) µm, (103.96 ± 10.33) µm correspondingly, they decreased significantly (P < 0.05). While the GCC thickness has no significantly difference among the MS-NON, MS-ON Contra and the control group. The average RNFL thickness and nasal inferior quadrant RNFL thickness in MS-ON group was (83.68 ± 29.91) µm, (92.26 ± 35.97) µm. And they were significantly thinner than that in the MS-NON group which was (108.83 ± 15.33) µm, (120.85 ± 35.96) µm correspondingly and that in the control group which was (111.60 ± 14.90) µm, (139.95 ± 7.77) µm correspondingly (P < 0.05). The RNFL thickness in temporal inferior quadrant in MS-ON group was (109.63 ± 44.54) µm and it was (60.47 ± 26.94) µm in the temporal quadrant. And they decreased significantly compared with that in the MS-NON which was (149.92 ± 18.51) µm, (90.64 ± 16.15) µm correspondingly, and in the MS-ON Contra group which was (135.70 ± 28.66) µm, (77.30 ± 23.40) µm correspondingly and in the control group which was (172.72 ± 15.29) µm,( 90.90 ± 6.15) µm correspondingly (P < 0.05). The RNFL thickness in nasal inferior, temporal inferior and temporal quadrant in the MS-ON Contra group was (106.60 ± 44.07) µm, (135.70 ± 28.66) µm, (77.30 ± 23.40) µm respectively which was significantly thinner than that in the control group which was (139.95 ± 7.77) µm, (172.72 ± 15.29) µm, (90.90 ± 6.15) µm correspondingly (P < 0.05).

CONCLUSIONS

GCC and RNFL thickness of OCT test can be used to evaluate the impairment of optic nerve of MS patients, and the RNFL scanning can reflect the early and latent lesion of optic nerve in MS.

摘要

目的

采用光学相干断层扫描(OCT)评估不同类型多发性硬化(MS)患者的视神经损伤情况。

方法

横断面研究。纳入30例符合2010年麦克唐纳标准诊断为MS的患者的52只眼。选取13例年龄和性别相匹配的健康人的13只眼作为对照组。MS患者根据视神经炎(ON)病史分为3个亚组:有ON病史的MS患者的22只眼纳入MS-ON组,无ON的MS患者的16只眼纳入MS-NON组,MS-ON患者的14只对侧眼纳入MS-ON Contra组。采用傅里叶域OCT进行检查。检查项目包括黄斑扫描、视网膜神经纤维层(RNFL)分析、神经节细胞复合体(GCC)及视神经乳头(ONH)扫描。同时比较视力(VA)和视野(VF)。主要测量指标为RNFL和GCC厚度。采用方差分析比较所有组间RNFL和GCC厚度的总体差异。采用LSD法比较每两组之间的差异。

结果

MS-ON组平均GCC、上方GCC和下方GCC厚度分别为(80.65±16.03)μm、(81.50±14.56)μm、(79.83±17.65)μm。与MS-NON组相应的(99.65±9.35)μm、(99.26±9.73)μm、(100.06±9.31)μm,MS-ON Contra组相应的(99.36±8.25)μm、(100.39±8.97)μm、(98.34±7.88)μm以及对照组相应的(104.87±8.71)μm、(105.36±8.21)μm、(103.96±10.33)μm相比,均显著降低(P<0.05)。而MS-NON组、MS-ON Contra组和对照组之间的GCC厚度无显著差异。MS-ON组平均RNFL厚度和鼻下象限RNFL厚度分别为(83.68±29.91)μm、(92.26±35.97)μm。与MS-NON组相应的(108.83±15.33)μm、(120.85±35.96)μm以及对照组相应的(111.60±14.90)μm、(139.95±7.77)μm相比,均显著变薄(P<0.05)。MS-ON组颞下象限RNFL厚度为(109.63±44.54)μm,颞象限为(60.47±26.94)μm。与MS-NON组相应的(149.92±18.51)μm、(90.64±16.15)μm,MS-ON Contra组相应的(135.70±28.66)μm、(77.30±23.40)μm以及对照组相应的(172.72±15.29)μm、(90.90±6.15)μm相比,均显著降低(P<0.05)。MS-ON Contra组鼻下、颞下和颞象限的RNFL厚度分别为(106.60±44.07)μm、(135.70±28.66)μm、(77.30±23.40)μm,均显著低于对照组相应的(139.95±7.77)μm、(172.72±15.29)μm、(90.90±6.15)μm(P<0.05)。

结论

OCT检测的GCC和RNFL厚度可用于评估MS患者的视神经损伤情况,RNFL扫描可反映MS患者视神经的早期及潜在病变。

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