Outteryck Olivier, Majed Bilal, Defoort-Dhellemmes Sabine, Vermersch Patrick, Zéphir Hélène
Department of Neurology, University of Lille, France
Emergency Department, Saint-Omer Region Hospital, France.
Mult Scler. 2015 Dec;21(14):1781-93. doi: 10.1177/1352458515578888. Epub 2015 Mar 31.
The aim of this study was to find, using spectral domain-optical coherence tomography (SD-OCT), retinal imaging biomarkers differentiating neuromyelitis optica spectrum disorder (NMOSD), multiple sclerosis (MS) and healthy controls (HCs).
The population was composed of patients with NMOSD (n=23) or MS (n=110) and of HCs (n=75). Evaluation criteria were retinal thickness/volume, visual acuity, low contrast vision acuity and Expanded Disability Status Scale score.
Considering all eyes and after statistical adjustments including the number of optic neuritis (ON) episodes, we found that NMOSD patients did not have significantly more retinal atrophy than MS patients; whereas MS non-optic neuritis (NON) eyes had thinner temporal (p=0.032) and temporo-superior peripapillary retinal nerve fibre layer (pRNFL; p=0.011) thicknesses than NMOSD NON eyes; in addition, NMOSD NON eyes presented significant naso-inferior pRNFL (p=0.024), temporal pRNFL (p=0.039), macular ganglion cell complex (p=0.004) and ganglion cell layer (p=0.002) atrophy vs HC eyes. We identified significant correlations between visual and clinical disability and retinal thicknesses in both diseases.
OCT may help to differentiate NMOSD and MS by focusing on the NON eyes (temporal pRNFL atrophy more severe in MS). Moreover, we discuss the possibility of a retinal degenerative process independent of ON in NMOSD.
本研究旨在利用频域光学相干断层扫描(SD - OCT)寻找可区分视神经脊髓炎谱系障碍(NMOSD)、多发性硬化症(MS)和健康对照者(HC)的视网膜成像生物标志物。
研究人群包括NMOSD患者(n = 23)、MS患者(n = 110)和HC(n = 75)。评估标准包括视网膜厚度/体积、视力、低对比度视力以及扩展残疾状态量表评分。
在纳入所有眼睛并进行包括视神经炎(ON)发作次数在内的统计调整后,我们发现NMOSD患者的视网膜萎缩并不比MS患者明显更多;而MS非视神经炎(NON)眼的颞侧(p = 0.032)和颞上象限视乳头周围视网膜神经纤维层(pRNFL;p = 0.011)厚度比NMOSD的NON眼更薄;此外,与HC眼相比,NMOSD的NON眼在鼻下象限pRNFL(p = 0.024)、颞侧pRNFL(p = 0.039)、黄斑神经节细胞复合体(p = 0.004)和神经节细胞层(p = 0.002)存在明显萎缩。我们还发现两种疾病的视力和临床残疾与视网膜厚度之间存在显著相关性。
OCT可能通过关注NON眼(MS中颞侧pRNFL萎缩更严重)来帮助区分NMOSD和MS。此外,我们讨论了NMOSD中存在独立于ON的视网膜退行性变过程的可能性。