Rzepiński Łukasz, Kucharczuk Jan, Maciejek Zdzisław, Grzybowski Andrzej, Parisi Vincenzo
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.
J Clin Med. 2021 Jun 29;10(13):2892. doi: 10.3390/jcm10132892.
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.
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。