视神经炎发病后一个月内视网膜神经节细胞层变薄。
Retinal ganglion cell layer thinning within one month of presentation for optic neuritis.
作者信息
Kupersmith Mark J, Garvin Mona K, Wang Jui-Kai, Durbin Mary, Kardon Randy
机构信息
New York Eye and Ear Infirmary, Mount Sinai Roosevelt Hospital, New York, USA
Department of Electrical and Computer Engineering, University of Iowa, Iowa, USA/Department of Ophthalmology, Iowa University School of Medicine and Center for Prevention and Treatment of Visual Loss, Iowa, USA.
出版信息
Mult Scler. 2016 Apr;22(5):641-8. doi: 10.1177/1352458515598020. Epub 2015 Sep 11.
BACKGROUND
Spectral domain optical coherence tomography (SD-OCT) reveals retinal ganglion cell layer plus inner plexiform layer (GCL+IPL) and peripapillary retinal nerve fiber layer (pRNFL) thinning in chronic optic nerve injury. At presentation, swelling of the pRNFL confounds evaluation of early axon loss.
OBJECTIVE
We studied whether the GCL+IPL thins before the pRNFL, the trajectory of GCL+IPL loss and relationship to vision.
METHODS
We prospectively evaluated 33 eyes (study) with new optic neuritis, using perimetry and SD-OCT with investigative three-dimensional layer segmentation and commercial two-dimensional segmentation to compute the GCL+IPL and pRNFL thickness.
RESULTS
At presentation, GCL+IPL thickness (82.4±8.8 µm) did not differ from unaffected fellow eyes (81.2±6.7 µm), via the three-dimensional method, while the two-dimensional method failed in 9% of study eyes. At 1-2 months, there was thinning of the pRNFL in 10% and of the GCL+IPL in 93% of study eyes. GCL+IPL reduction was greatest during the first 2 months. GCL+IPL thinning at 1-2 months correlated with GCL+IPL thinning at 6 months (r=0.84, P=0.01) and presentation visual acuity (r=0.48, P=0.006) and perimetric mean deviation (r=0.52, P=0.003).
CONCLUSION
GGL+IPL is an early biomarker of structural injury in optic neuritis as thinning develops within 1-2 months of onset, prior to pRNFL thinning.
背景
光谱域光学相干断层扫描（SD - OCT）显示，在慢性视神经损伤中视网膜神经节细胞层加内核层（GCL + IPL）以及视乳头周围视网膜神经纤维层（pRNFL）变薄。在疾病初发时，pRNFL的肿胀会干扰早期轴突损失的评估。
目的
我们研究了GCL + IPL是否比pRNFL更早变薄、GCL + IPL损失的轨迹以及与视力的关系。
方法
我们前瞻性地评估了33只患有新发视神经炎的眼睛（研究组），使用视野检查和SD - OCT，通过研究性三维层分割和商业二维分割来计算GCL + IPL和pRNFL的厚度。
结果
在疾病初发时，通过三维方法测量，研究组眼睛的GCL + IPL厚度（82.4±8.8μm）与未受影响的对侧眼睛（81.2±6.7μm）没有差异，而二维方法在9%的研究组眼睛中测量失败。在1 - 2个月时，10%的研究组眼睛pRNFL变薄，93%的研究组眼睛GCL + IPL变薄。GCL + IPL在最初2个月内减少最多。1 - 2个月时GCL + IPL变薄与6个月时GCL + IPL变薄相关（r = 0.84，P = 0.01），也与初发时的视力相关（r = 0.48，P = 0.006）以及视野平均偏差相关（r = 0.52，P = 0.003）。
结论
GCL + IPL是视神经炎结构损伤的早期生物标志物，因为在发病后1 - 2个月内就会出现变薄，早于pRNFL变薄。
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