颞侧视网膜神经纤维层厚度是多发性硬化症中最重要的光学相干断层扫描评估指标。
The Temporal Retinal Nerve Fiber Layer Thickness Is the Most Important Optical Coherence Tomography Estimate in Multiple Sclerosis.
作者信息
Birkeldh Ulrika, Manouchehrinia Ali, Hietala Max Albert, Hillert Jan, Olsson Tomas, Piehl Fredrik, Kockum Ingrid Skelton, Brundin Lou, Zahavi Ori, Wahlberg-Ramsay Marika, Brautaset Rune, Nilsson Maria
机构信息
Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institute at Karolinska University Hospital Solna, Stockholm, Sweden.
出版信息
Front Neurol. 2017 Dec 13;8:675. doi: 10.3389/fneur.2017.00675. eCollection 2017.
BACKGROUND
Reduced peripapillary retinal nerve fiber layer (pRNFL) and combined ganglion cell and inner plexiform layer (GCIP) thicknesses as measured by optical coherence tomography (OCT) have been observed in multiple sclerosis (MS) patients. The purpose was to determine the most associative OCT measure to level of cognitive and physical disability in MS.
METHODS
Data were collected from 546 MS patients and 175 healthy controls (HCs). We compared the average pRNFL, temporal pRNFL (T-pRNFL), overall inner ganglion cell/inner plexiform layer (GCIP), and the overall ganglion cell complex (GCC) including macular RNFL and GCIP thicknesses measurements in differentiating MS subtypes from HCs. The association between OCT measures, Expanded Disability Status Scale (EDSS), and Symbol Digit Modalities Test (SDMT) were assessed using generalized estimating equations models.
RESULTS
Both peripapillary and macular OCT measurements could differentiate all MS subtypes from HCs. The SDMT score was significantly associated with reduced thickness of all OCT measures, mostly in average pRNFL (0.14 µm, = 0.001) and T-pRNFL (0.17 µm, < 0.001). The EDSS score was significantly associated with reduced inner retinal layer thickness. The largest reduction was seen in T-pRNFL (-1.52 μm, < 0.001) and inner GCC (-1.78 μm, < 0.001).
CONCLUSION
The T-pRNFL is highly sensitive and associated with level of both cognitive and physical disability.
背景
通过光学相干断层扫描（OCT）测量发现，多发性硬化症（MS）患者的视乳头周围视网膜神经纤维层（pRNFL）以及联合神经节细胞和内丛状层（GCIP）厚度均有所降低。目的是确定与MS患者认知和身体残疾程度最相关的OCT测量指标。
方法
收集了546例MS患者和175例健康对照者（HCs）的数据。我们比较了平均pRNFL、颞侧pRNFL（T-pRNFL）、整体内神经节细胞/内丛状层（GCIP）以及包括黄斑RNFL和GCIP厚度测量在内的整体神经节细胞复合体（GCC），以区分MS亚型与HCs。使用广义估计方程模型评估OCT测量指标、扩展残疾状态量表（EDSS）和符号数字模态测验（SDMT）之间的关联。
结果
视乳头周围和黄斑OCT测量均可区分所有MS亚型与HCs。SDMT评分与所有OCT测量指标的厚度降低显著相关，主要是平均pRNFL（0.14μm，P = 0.001）和T-pRNFL（0.17μm，P < 0.001）。EDSS评分与视网膜内层厚度降低显著相关。T-pRNFL（-1.52μm，P < 0.001）和内GCC（-1.78μm，P < 0.001）的降低最为明显。
结论
T-pRNFL高度敏感，且与认知和身体残疾程度均相关。
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