Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States.
Invest Ophthalmol Vis Sci. 2018 Jan 1;59(1):196-201. doi: 10.1167/iovs.17-22391.
Precise measurements of visual fixation and its instability were recorded during optical coherence tomography (OCT) as a marker of neural network dysfunction in multiple sclerosis (MS), which could be used to monitor disease progression or response to treatment.
A total of 16 MS patients and 26 normal subjects underwent 30 seconds of scanning laser ophthalmoscope (SLO)-based eye tracking during OCT scanning of retinal layer thickness. Study groups consisted of normal eyes, MS eyes without prior optic neuritis (MS wo ON), and MS eyes with prior optic neuritis (MS + ON). Kernel density estimation quantified fixation instability from the distribution of fixation points on the retina. In MS wo ON eyes, fixation instability was compared to other measures of visual and neurologic function.
Fixation instability was increased in MS wo ON eyes (0.062 deg2) compared to normal eyes (0.030 deg2, P = 0.015). A further increase was seen for MS + ON eyes (0.11 deg2) compared to MS wo ON (P = 0.04) and normal (P = 0.006) eyes. Fixation instability correlated weakly with ganglion cell layer (GCL) volume and showed no correlation with low-contrast letter acuity, EDSS score, or SDMT score.
Fixation instability reflects the integrity of a widespread neural network germane to visual processing and ocular motor control, and is disturbed in MS. Further study of visual fixation, including the contribution of microsaccades to fixation instability, may provide insight into the localization of fixation abnormalities in MS and introduce innovative and easily measured outcomes for monitoring progression and treatment response.
在光学相干断层扫描 (OCT) 期间记录视觉固视及其不稳定性的精确测量值，作为多发性硬化症 (MS) 神经网络功能障碍的标志物，可用于监测疾病进展或对治疗的反应。
共有 16 名 MS 患者和 26 名正常受试者在视网膜层厚度的 OCT 扫描期间接受了 30 秒的扫描激光检眼镜 (SLO) 眼部跟踪。研究组包括正常眼、无先前视神经炎的 MS 眼 (MS wo ON) 和有先前视神经炎的 MS 眼 (MS + ON)。核密度估计从视网膜上的固定点分布量化了固定不稳定性。在 MS wo ON 眼中，将固定不稳定性与其他视觉和神经功能测量值进行了比较。
与正常眼 (0.030 deg2，P = 0.015) 相比，MS wo ON 眼中的固定不稳定性增加 (0.062 deg2)。与 MS wo ON (P = 0.04) 和正常 (P = 0.006) 眼相比，MS + ON 眼的固定不稳定性进一步增加。固定不稳定性与神经节细胞层 (GCL) 体积弱相关，与低对比度字母视力、EDSS 评分或 SDMT 评分均无相关性。
固定不稳定性反映了与视觉处理和眼球运动控制相关的广泛神经网络的完整性，并且在 MS 中受到干扰。对视觉固定的进一步研究，包括微扫视对固定不稳定性的贡献，可能有助于了解 MS 中固定异常的定位，并引入创新且易于测量的监测进展和治疗反应的结果。
