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初治临床孤立综合征及不同类型多发性硬化患者的频域光学相干断层扫描评估:研究结果及与残疾状态的关系

Spectral-Domain Optical Coherence Tomography Assessment in Treatment-Naïve Patients with Clinically Isolated Syndrome and Different Multiple Sclerosis Types: Findings and Relationship with the Disability Status.

作者信息

Rzepiński Łukasz, Kucharczuk Jan, Maciejek Zdzisław, Grzybowski Andrzej, Parisi Vincenzo

机构信息

Department of Neurology, 10th Military Research Hospital and Polyclinic, Powstańców Warszawy 5, 85-681 Bydgoszcz, Poland.

Neurology Department, Sanitas-Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland.

出版信息

J Clin Med. 2021 Jun 29;10(13):2892. doi: 10.3390/jcm10132892.

Abstract

This study evaluates the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV) using spectral-domain optical coherence tomography in treatment naïve patients with the clinically isolated syndrome (CIS) and different multiple sclerosis (MS) types. A total of 126 patients (15 CIS, 65 relapsing-remitting MS, 14 secondary progressive MS, 11 primary progressive MS, 21 benign MS) with or without optic neuritis (ON) history and 63 healthy age-similar controls were assessed. Concerning controls' eyes, pRNFL thickness was significantly reduced in CIS-ON eyes ( < 0.01), while both TMV and pRNFL thickness was decreased in all MS eyes regardless of ON history ( < 0.01). Significant differences in pRNFL thickness and TMV between MS variants were observed for non-ON eyes ( < 0.01), with the lowest values in benign and secondary progressive disease type, respectively. The pRNFL thickness was inversely correlated with Expanded Disability Status Scale (EDSS) score in non-ON subgroups ( < 0.01), whereas TMV was inversely correlated with EDSS score in both ON and non-ON subgroups ( < 0.01). Concluding, pRNFL thinning confirms optic nerve damage in CIS-ON eyes and appears to be disproportionately high with respect to the disability status of benign MS patients. The values of TMV and pRNFL in non-ON eyes significantly correspond to MS course heterogeneity and patients' disability than in ON eyes.

摘要

本研究采用光谱域光学相干断层扫描技术,评估未经治疗的临床孤立综合征(CIS)患者及不同类型多发性硬化症(MS)患者的视乳头周围视网膜神经纤维层(pRNFL)厚度和黄斑总体积(TMV)。共评估了126例患者(15例CIS、65例复发缓解型MS、14例继发进展型MS、11例原发进展型MS、21例良性MS),这些患者有或无视神经炎(ON)病史,同时纳入了63例年龄相仿的健康对照者。在对照者眼中,CIS合并ON的患眼pRNFL厚度显著降低(<0.01),而无论有无ON病史,所有MS患眼的TMV和pRNFL厚度均降低(<0.01)。在无ON的患眼中,观察到MS各亚型之间pRNFL厚度和TMV存在显著差异(<0.01),分别在良性和继发进展型疾病类型中出现最低值。在无ON的亚组中,pRNFL厚度与扩展残疾状态量表(EDSS)评分呈负相关(<0.01),而在有ON和无ON的亚组中,TMV均与EDSS评分呈负相关(<0.01)。综上所述,pRNFL变薄证实了CIS合并ON患眼的视神经损伤,并且相对于良性MS患者的残疾状态而言,其程度似乎过高。与有ON的患眼相比,无ON患眼中TMV和pRNFL的值与MS病程异质性及患者残疾程度显著相关。

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