Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
Department of Ophthalmology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
Acta Ophthalmol. 2018 May;96(3):e309-e314. doi: 10.1111/aos.13571. Epub 2017 Nov 1.
Assessment of retinal oxygen saturation, thickness of a retinal nerve fibre layer (RNFL) and functional changes in the optic nerve during optic neuritis (ON) in patients with multiple sclerosis (MS).
Thirty-two patients with ON due to MS within 3 months of onset of symptoms were enrolled [22 females, 10 males, age 34 ± 9 years, median 32.5 years, 22 patients with the clinically isolated syndrome (CIS), 10 patients with relapsing-remitting from of MS (RRMS)]. All patients were examined using optical coherence tomography (OCT model 4000, Carl Zeiss Meditec, Dublin, CA, USA), automatic optical oximetry (Oxymap ehf, Reykjavik, Iceland) and using visual evoked potentials (VEP) (Metronic Keypoint , Minneapolis, MN, USA).
Arterio-venous difference (AVD) was increased in patients ON affected eye compared to patients' unaffected eye (PUE) [34.2 ± 4.7 versus 31.3 ± 4.6, p = 0.044 (mean ± standard deviation)]. No statistically significant difference was found in vessel oxygen saturation as well as in RNFL thickness in ON affected eyes when compared to unaffected MS eyes and healthy individuals. Significantly lower optic nerve conduction velocity was found in the affected eye when compared to unaffected MS eye and healthy (p < 0.0001 for both comparisons). No correlation between oxygen saturation values and VEP was observed in patients with MS.
The AVD in oxygen saturation is altered in patients with acute ON. In the early stage of ON, AVD could reflect inflammatory and metabolic changes in the affected eye. Therefore, oximetry could be used as another diagnostic method in MS patients in suspicion of ON. This result would be promising for future investigation in this field.
评估多发性硬化症（MS）患者视神经炎（ON）期间视网膜氧饱和度、视网膜神经纤维层（RNFL）厚度和视神经功能变化。
共纳入 32 例发病 3 个月内的 MS 相关 ON 患者[22 例女性，10 例男性，年龄 34±9 岁，中位数 32.5 岁，22 例为临床孤立综合征（CIS），10 例为复发缓解型 MS（RRMS）]。所有患者均接受光学相干断层扫描（OCT 型号 4000，德国卡尔蔡司公司，都柏林，加利福尼亚州，美国）、自动光学血氧测定（Oxymap ehf，雷克雅未克，冰岛）和视觉诱发电位（VEP）（Metronic Keypoint ，明尼苏达州，美国）检查。
与对侧眼（PUE）相比，ON 患眼的动静脉差（AVD）增加[34.2±4.7 比 31.3±4.6，p=0.044（均值±标准差）]。ON 患眼与 PUE 和健康对照组相比，血管血氧饱和度和 RNFL 厚度无统计学差异。与 PUE 和健康对照组相比，ON 患眼的视神经传导速度明显较低（两者比较 p<0.0001）。MS 患者的血氧饱和度值与 VEP 之间无相关性。
急性 ON 患者的 AVD 氧饱和度发生改变。在 ON 的早期阶段，AVD 可能反映了受累眼的炎症和代谢变化。因此，血氧测定可作为怀疑 ON 的 MS 患者的另一种诊断方法。这一结果为该领域的进一步研究提供了有希望的依据。
