Altıntaş Ayşe, Yildiz-Tas Ayse, Yilmaz Sezen, Bayraktutar Betul N, Comert Melis Cansu, Zimmermann Hanna, Brandt Alexander U, Paul Friedemann, Sahin Afsun
Neurology Department, School of Medicine, Koç University, Istanbul, Turkey.
Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey.
Mult Scler J Exp Transl Clin. 2021 Mar 19;7(1):2055217321998060. doi: 10.1177/2055217321998060. eCollection 2021 Jan-Mar.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory autoimmune disorder that damages optic nerves, brainstem, and spinal cord. In vivo corneal confocal microscopy (IVCM) is a noninvasive technique that provides corneal images with dendritic cells (DCs) and corneal subbasal nerve plexus (SBP), which arises from the trigeminal nerve.
We investigated corneal SBP changes in NMOSD and proposed IVCM as a potential new disease severity biomarker for NMOSD.
Seventeen age-sex matched NMOSD patients and 19 healthy participants underwent complete neurologic and ophthalmologic examinations. The duration of disease, first symptom, presence of optic neuritis attack, antibody status, Expanded Disability Status Scale(EDSS) score and disease severity score(DSS) were recorded. Retinal nerve fibre layer (RNFL) thickness was measured with optical coherence tomography, and corneal SBP images were taken with IVCM.
NMOSD patients had significantly reduced corneal nerve fibre lenght-density and corneal nerve branch lenght-density compared with controls, while DC density was increased. NMOSD patients also showed significantly reduced RNFL thickness compared with controls. EDSS,DSS levels were inversely correlated with IVCM parameters.
We observed significant corneal nerve fibre loss in NMOSD patients in relation to disease severity. IVCM can be a candidate noninvasive imaging method for axonal damage assessment in NMOSD that warrants further investigation.
视神经脊髓炎谱系障碍（NMOSD）是一种炎症性自身免疫性疾病，会对视神经、脑干和脊髓造成损害。体内角膜共焦显微镜检查（IVCM）是一种非侵入性技术，可提供含有树突状细胞（DC）和源自三叉神经的角膜基底神经丛（SBP）的角膜图像。
我们研究了NMOSD患者角膜SBP的变化，并提出IVCM作为NMOSD潜在的新的疾病严重程度生物标志物。
17例年龄和性别匹配的NMOSD患者和19名健康参与者接受了全面的神经和眼科检查。记录疾病持续时间、首发症状、视神经炎发作情况、抗体状态、扩展残疾状态量表（EDSS）评分和疾病严重程度评分（DSS）。用光学相干断层扫描测量视网膜神经纤维层（RNFL）厚度，并用IVCM拍摄角膜SBP图像。
与对照组相比，NMOSD患者的角膜神经纤维长度密度和角膜神经分支长度密度显著降低，而DC密度增加。与对照组相比，NMOSD患者的RNFL厚度也显著降低。EDSS、DSS水平与IVCM参数呈负相关。
我们观察到NMOSD患者角膜神经纤维的显著丧失与疾病严重程度有关。IVCM可以作为一种用于评估NMOSD轴突损伤的非侵入性成像方法的候选者，值得进一步研究。
