Department of Neuroscience (MC, LP, NB, GB, GN, CL, ES, AU, MI), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy ; Departments of Neurology (MP, MI), Icahn School of Medicine at Mount Sinai, New York, New York; and Department of Neurology (AU, MI) Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
J Neuroophthalmol. 2021 Sep 1;41(3):329-334. doi: 10.1097/WNO.0000000000001165.
Data regarding the predictive value of optical coherence tomography (OCT)-derived measures are lacking, especially in progressive multiple sclerosis (PMS). Accordingly, we aimed at investigating whether a single OCT assessment can predict a disability risk in both relapsing-remitting MS (RRMS) and PMS.
One hundred one patients with RRMS and 79 patients with PMS underwent Spectral-Domain OCT, including intraretinal layer segmentation. All patients had at least 1 Expanded Disability Status Scale (EDSS) measurement during the subsequent follow-up (FU). Differences in terms of OCT metrics and their association with FU disability were assessed by analysis of covariance and linear regression models, respectively.
The median FU was 2 years (range 1-5.5 years). The baseline peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell + inner plexiform layer (GCIPL) were thinner in PMS compared with RRMS (P = 0.02 and P = 0.003, respectively). In the RRMS population, multivariable models showed that the GCIPL significantly correlated with FU disability (0.04 increase in the EDSS for each 1-μm decrease in the baseline GCIPL, 95% confidence interval: 0.006-0.08; P = 0.02). The baseline GCIPL was thinner in patients with RRMS with FU-EDSS >4 compared with those with FU-EDSS ≤4, and individuals in the highest baseline GCIPL tertile had a significantly lower FU-EDSS score than those in the middle and lowest tertile (P = 0.01 and P = 0.001, respectively). These findings were not confirmed in analyses restricted to patients with PMS.
Among OCT-derived metrics, GCIPL thickness had the strongest association with short-medium term disability in patients with RRMS. The predictive value of OCT metrics in the longer term will have to be further investigated, especially in PMS.
缺乏光学相干断层扫描（OCT）衍生指标的预测价值的数据，尤其是在进展性多发性硬化症（PMS）中。因此，我们旨在研究单次 OCT 评估是否可以预测 RRMS 和 PMS 患者的残疾风险。
101 例 RRMS 患者和 79 例 PMS 患者接受了光谱域 OCT 检查，包括视网膜内部分层。所有患者在随后的随访（FU）期间至少有 1 次扩展残疾状况量表（EDSS）测量。通过协方差分析和线性回归模型分别评估 OCT 指标的差异及其与 FU 残疾的相关性。
中位 FU 为 2 年（范围 1-5.5 年）。与 RRMS 相比，PMS 的基线视盘周围视网膜神经纤维层（pRNFL）和节细胞+内丛状层（GCIPL）较薄（P = 0.02 和 P = 0.003）。在 RRMS 人群中，多变量模型显示 GCIPL 与 FU 残疾显著相关（基线 GCIPL 每减少 1μm，EDSS 增加 0.04，95%置信区间：0.006-0.08；P = 0.02）。与 FU-EDSS ≤4 的患者相比，FU-EDSS >4 的 RRMS 患者的基线 GCIPL 较薄，而基线 GCIPL 最高三分位的个体的 FU-EDSS 评分明显低于中间和最低三分位的个体（P = 0.01 和 P = 0.001）。这些发现在仅限于 PMS 患者的分析中未得到证实。
在 OCT 衍生指标中，GCIPL 厚度与 RRMS 患者的中短期残疾相关性最强。OCT 指标在较长时间内的预测价值尚需进一步研究，尤其是在 PMS 中。
