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视神经脊髓炎单侧视神经炎患者健侧眼视网膜神经纤维层厚度及视神经功能评估

Evaluation of retinal nerve fiber layer thickness and optic nerve functions in fellow eye of neuromyelitis optica with unilateral optic neuritis.

作者信息

Ong Chin Feng Wendy, Wan Hitam Wan Hazabbah

机构信息

Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.

出版信息

Taiwan J Ophthalmol. 2020 Jun 20;10(3):189-196. doi: 10.4103/tjo.tjo_22_20. eCollection 2020 Jul-Sep.

Abstract

PURPOSE

Peripapillary retinal nerve fibre layer (RNFL) thickness might be useful in monitoring ongoing subclinical structural damage especially in eyes with no history of optic neuritis (ON) in neuromyelitis optica (NMO).

OBJECTIVE

To evaluate the peripapillary RNFL thickness and optic nerve functions in fellow eye of NMO with unilateral optic neuritis.

MATERIALS AND METHODS

A comparative cross-sectional study was conducted in 2 tertiary hospitals from August 2017 to May 2019. RNFL thickness and optic nerve functions were evaluated. Statistical analysis was performed using Statistical Package for Social Science version 24.

RESULTS

A total of 26 NMO patients and 26 controls were involved in this study. The median age (IQR) of NMO patients was 32.5 (12) years old. The RNFL thickness was significantly reduced in NMO patients with non-ON eyes as compared to control group. Best corrected visual acuity between the 2 groups were comparable (0.20 vs 0.00, p=0.071). Contrast sensitivity was also reduced in NMO patients (non-ON eyes) at all 5 spatial frequencies. In NMO group, 34.6% have normal colour vision. The mean deviation (MD) of Humphrey visual field (HVF) was higher in NMO group (p<0.001). There was a moderate correlation between RNFL thickness and contrast sensitivity. Weak correlation was found between the RNFL thickness with visual acuity and mean deviation of visual field test.

CONCLUSION

Our study showed that the fellow eye of NMO patients with unilateral ON revealed a significant reduction in RNFL thickness and all the optic nerve functions have subtle early changes that signify a subclinical retinal damage.

摘要

目的

视乳头周围视网膜神经纤维层(RNFL)厚度可能有助于监测正在发生的亚临床结构损伤,尤其是在视神经脊髓炎(NMO)中无视神经炎(ON)病史的眼睛。

目的

评估单侧视神经炎的NMO患者对侧眼的视乳头周围RNFL厚度和视神经功能。

材料与方法

2017年8月至2019年5月在2家三级医院进行了一项对比横断面研究。评估了RNFL厚度和视神经功能。使用社会科学统计软件包第24版进行统计分析。

结果

本研究共纳入26例NMO患者和26例对照。NMO患者的中位年龄(四分位间距)为32.5(12)岁。与对照组相比,非ON眼的NMO患者的RNFL厚度显著降低。两组之间的最佳矫正视力相当(0.20对0.00,p = 0.071)。NMO患者(非ON眼)在所有5个空间频率下的对比敏感度也降低。在NMO组中,34.6%的患者色觉正常。NMO组的 Humphrey视野(HVF)平均偏差(MD)更高(p<0.001)。RNFL厚度与对比敏感度之间存在中度相关性。RNFL厚度与视力和视野测试平均偏差之间存在弱相关性。

结论

我们的研究表明,单侧ON的NMO患者的对侧眼RNFL厚度显著降低,并且所有视神经功能都有细微的早期变化,这表明存在亚临床视网膜损伤。

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