Isfahan neurosciences research center, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Advanced Technologies in Medicine, Medical Image & Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Mult Scler Relat Disord. 2021 Jan;47:102625. doi: 10.1016/j.msard.2020.102625. Epub 2020 Nov 14.
The aim of this study was to identify and compare the characteristics of retinal nerve layers using spectral domain-optical coherence tomography (SD-OCT) in neuromyelitis optica spectrum disorder (NMOSD), relapsing-remitting multiple sclerosis (RRMS) and healthy controls (HCs).
It is a cross-sectional population-based study in Isfahan, Iran. We enrolled 98 participants including 45 NMOSD patients (90 eyes), 35 RRMS patients (70 eyes) and 18 HCs (36 eyes). Evaluation criteria were thickness of different sectors in peripapillary retinal nerve fiber layer (pRNFL) and intra-retinal layers around the macula. History of previous optic neuritis (ON) was obtained through chart review and medical record.
Without considering ON, total macular, ganglion cell layer (GCL) and pRNFL were significantly thinner in both groups of patients compared to HCs. On macular examination, GCL and total macular thickness were significantly thinner than HCs in all NMOSD and RRMS eyes with and without history of ON. While there was no significant difference between MS-ON and MS without a history of ON in the macular measures, the reduction in total macular and GCL thickness was significantly greater in NMOSD-ON compared to NMOSD without a history of ON. Also in NMOSD-ON eyes, the RNFL, GCL, IPL and GCIPL layers were significantly thinner than that of MS-ON. On the other hand, the pRNFL study showed significant thinning of all quadrants in the RRMS and NMOSD groups relative to HCs. While the decrease of pRNFL thickness in the eyes of NMOSD-ON and MS with and without a previous history of ON was significantly greater than that of HCs, no difference was observed between NMOSD without ON and HCs. In addition, in NMOSD patients, pRNFL was significantly thinner in eyes with history of ON compared to non ON-eyes. Furthermore, in patients with a history of ON, reduction in all sectors of pRNFl (except in T) was significantly greater in NMOSD compared to MS patients.
Our findings showed that although macular and retinal damage occurred in both NMOSD and RRMS patients without significant differences, the severity of injury in eyes with history of ON was significantly higher in NMOSD compared to MS patients, that could be considered as a marker to distinguish them. In addition, our results confirmed the absence of subclinical optic nerve involvement in NMOSD unlike MS patients.
本研究旨在通过频域光学相干断层扫描（SD-OCT）识别并比较视神经脊髓炎谱系障碍（NMOSD）、复发缓解型多发性硬化症（RRMS）和健康对照组（HCs）的视网膜神经层特征。
这是一项在伊朗伊斯法罕进行的基于人群的横断面研究。我们纳入了 98 名参与者，包括 45 名 NMOSD 患者（90 只眼）、35 名 RRMS 患者（70 只眼）和 18 名 HCs（36 只眼）。评估标准为视盘周围视网膜神经纤维层（pRNFL）和黄斑周围视网膜内各层的不同节段厚度。通过病历回顾和医疗记录获取既往视神经炎（ON）病史。
不考虑 ON 的情况下，与 HCs 相比，两组患者的全黄斑、神经节细胞层（GCL）和 pRNFL 均显著变薄。在黄斑检查中，NMOSD 和 RRMS 患者中所有有和无 ON 病史的眼的 GCL 和全黄斑厚度均显著低于 HCs。而在 MS-ON 和无 MS 病史的 ON 眼之间，黄斑测量值无显著差异，但 NMOSD-ON 与 NMOSD 无 ON 病史相比，全黄斑和 GCL 厚度的减少更为显著。此外，NMOSD-ON 眼的 RNFL、GCL、内丛状层（IPL）和节细胞内丛状层（GCIPL）均明显变薄。另一方面，RRMS 和 NMOSD 组的 pRNFL 研究显示，与 HCs 相比，所有象限均显著变薄。NMOSD-ON 和有和无既往 ON 病史的 MS 眼的 pRNFL 厚度下降明显大于 HCs，但 NMOSD 无 ON 眼与 HCs 之间无差异。此外，在 NMOSD 患者中，有 ON 病史的眼的 pRNFL 明显薄于无 ON 眼。此外，在有 ON 病史的患者中，与 MS 患者相比，NMOSD 患者 pRNFL 各象限（T 除外）的减少均更为显著。
我们的研究结果表明，尽管 NMOSD 和 RRMS 患者的黄斑和视网膜损伤无明显差异，但 NMOSD 患者有 ON 病史的眼损伤严重程度明显高于 MS 患者，这可作为区分两者的标志。此外，我们的结果证实，NMOSD 患者视神经不存在亚临床受累，而 MS 患者则存在。
