Baltimore VA Medical Center, Baltimore, MD, USA/University of Maryland Medical Center, Baltimore, MD, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Mult Scler. 2022 Mar;28(3):393-405. doi: 10.1177/13524585211023343. Epub 2021 Jun 14.
Retinal atrophy in multiple sclerosis (MS) as measured by optical coherence tomography (OCT) correlates with demyelinating lesions and brain atrophy, but its relationship with cortical lesions (CLs) and meningeal inflammation is not well known.
To evaluate the relationship of retinal layer atrophy with leptomeningeal enhancement (LME) and CLs in MS as visualized on 7 Tesla (7T) magnetic resonance imaging (MRI).
Forty participants with MS underwent 7T MRI of the brain and OCT. Partial correlation and mixed-effects regression evaluated relationships between MRI and OCT findings.
All participants had CLs and 32 (80%) participants had LME on post-contrast MRI. Ganglion cell/inner plexiform layer (GCIPL) thickness correlated with total CL volume ( =-0.45, < 0.01). Participants with LME at baseline had thinner macular retinal nerve fiber layer (mRNFL; = 0.01) and GCIPL ( < 0.01). Atrophy in various retinal layers was faster in those with certain patterns of LME. For example, mRNFL declined -1.113 (-1.974, -0.252) μm/year faster in those with spread/fill-pattern LME foci at baseline compared with those without ( = 0.01).
This study associates MRI findings of LME and cortical pathology with thinning of retinal layers as measured by OCT, suggesting a common link between meningeal inflammation, CLs, and retinal atrophy in MS.
多发性硬化症（MS）患者的视网膜萎缩通过光学相干断层扫描（OCT）测量，与脱髓鞘病变和脑萎缩相关，但与皮质病变（CLs）和脑膜炎症的关系尚不清楚。
评估多发性硬化症患者视网膜层萎缩与 7 特斯拉（7T）磁共振成像（MRI）上可见的软脑膜增强（LME）和 CLs 的关系。
40 名 MS 患者接受了大脑和 OCT 的 7T MRI 检查。偏相关和混合效应回归评估了 MRI 和 OCT 结果之间的关系。
所有参与者均有 CLs，32 名（80%）参与者在对比后 MRI 上有 LME。神经节细胞/内丛状层（GCIPL）厚度与总 CL 体积呈负相关（ =-0.45， < 0.01）。基线时有 LME 的参与者的黄斑视网膜神经纤维层（mRNFL； = 0.01）和 GCIPL 较薄（ < 0.01）。在具有某些 LME 模式的患者中，各种视网膜层的萎缩速度更快。例如，与基线时无 LME 病灶的患者相比，具有弥散/填充模式 LME 病灶的患者的 mRNFL 每年更快地下降-1.113（-1.974，-0.252）μm（ = 0.01）。
本研究将 LME 和皮质病理学的 MRI 发现与 OCT 测量的视网膜层变薄相关联，表明 MS 中脑膜炎症、CLs 和视网膜萎缩之间存在共同联系。
