Department of Neurology, Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon; Department of Neurology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Neurology, Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Mult Scler Relat Disord. 2021 Aug;53:103041. doi: 10.1016/j.msard.2021.103041. Epub 2021 May 23.
To explore prospectively through OCT the rate of retinal layer changes in relapsing-remitting multiple sclerosis patients followed up on fingolimod or interferon, as well as the treatments' differential effects on cognitive tests scores.
This prospective observational study enrolled 128 stable RRMS patients treated either with fingolimod (n = 71) or interferon (n = 56). Symbol-Digit Modality Test and retinal OCT scans were obtained at baseline and every 6 to 12 months. A subgroup of patients underwent expanded cognitive tests annually (Brief visual-spatial memory-total recall, BVMT-delayed recall, and Montreal Cognitive Assessment). Retinal-OCT scans were also obtained from 22 age- and sex-matched healthy controls. Mixed effects regression was used to study annualized changes in retinal layers and cognitive function, including differences between treatment groups. Correlations between annualized changes in retinal measurements and cognitive scores were also explored.
Fingolimod treated patients showed no significant difference in the rate of thinning of all retinal layers when compared to healthy controls and had significantly less GCIPL thinning when compared to interferons. SDMT scores improved similarly among both RRMS treatment groups. However, interferon but not fingolimod treated patients had significant decline in MOCA and total recall scores. We also found correlations between the annualized change in GCIPL thickness and annualized change in MOCA scores, and similar correlations with annualized change in total recall scores.
Fingolimod has a potential role in reducing retinal neurodegeneration in RRMS. Longitudinal OCT measures appear to be sensitive to changes in cognitive function and may be useful for monitoring neuroprotective therapies.
通过 OCT 前瞻性地研究接受芬戈莫德或干扰素治疗的复发缓解型多发性硬化症（RRMS）患者的视网膜层变化率，以及两种治疗方法对认知测试评分的差异影响。
本前瞻性观察性研究纳入了 128 例稳定的 RRMS 患者，分别接受芬戈莫德（n=71）或干扰素（n=56）治疗。在基线和每 6-12 个月时进行符号数字模态测试和视网膜 OCT 扫描。一部分患者每年进行扩展认知测试（简短视觉空间记忆-总回忆、BVMT-延迟回忆和蒙特利尔认知评估）。还从 22 名年龄和性别匹配的健康对照者中获得了视网膜 OCT 扫描。采用混合效应回归分析研究视网膜层和认知功能的年度变化，包括治疗组之间的差异。还探索了视网膜测量和认知评分的年度变化之间的相关性。
与健康对照组相比，芬戈莫德治疗组的所有视网膜层变薄速度无显著差异，与干扰素相比，其 GCIPL 变薄速度明显更慢。SDMT 评分在 RRMS 两种治疗组中均有相似的改善。然而，干扰素而非芬戈莫德治疗组的 MOCA 和总回忆评分显著下降。我们还发现 GCIPL 厚度的年化变化与 MOCA 评分的年化变化之间存在相关性，与总回忆评分的年化变化也存在相似的相关性。
芬戈莫德在 RRMS 中可能具有减轻视网膜神经退行性变的作用。纵向 OCT 测量似乎对认知功能的变化敏感，可能有助于监测神经保护治疗。
