Estiasari Riwanti, Diwyacitta Adisresti, Sidik Muhammad, Rida Ariarini Ni Nengah, Sitorus Freddy, Marwadhani Saraf Shafa, Maharani Kartika, Imran Darma, Arpandy Reza Aditya, Pangeran David, Hakim Manfaluthy
Department of Neurology, Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia.
Department of Ophtalmology, Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia.
Neurol Res Int. 2021 Jun 17;2021:5573839. doi: 10.1155/2021/5573839. eCollection 2021.
Multiple sclerosis (MS) is an autoimmune disease characterized by inflammation and demyelination of the central nervous system which often involves the optic nerve even though only 20% of the patients experience optic neuritis (ON).
This study aims to compare the retinal structure and optic nerve function between patients with MS and healthy controls (HCs), evaluate optic nerve alterations in MS over 1-year follow-up, and analyze its correlations with disease duration, number of relapses, degree of disability, and different subtypes.
This is a prospective cohort study involving 58 eyes of MS patients. Optic nerve function was evaluated with best-corrected visual acuity (BCVA), contrast sensitivity, and P100 latency, while the retinal structure was evaluated from the GCIPL and RNFL thickness measured with optical coherence tomography (OCT) and fundus photography.
The MS group had lower BCVA (=0.001), contrast sensitivity ( < 0.001), mean GCIPL thickness ( < 0.001), and mean RNFL thickness ( < 0.001) than HC. At 6 and 12 months of observations, GCIPL and RNFL (nasal quadrant) of MS patients decreased significantly (=0.007 and =0.004, respectively). Disease duration and the number of relapses correlated with delayed P100 latency ( = -0.61, < 0.001 and = -0.46, =0.02). GCIPL and RNFL in the SPMS subtype were thinner than in RRMS.
The retinal structure and optic nerve function of MS patients are worse than those of normal individuals. GCIPL and RNFL thinning occurs at 6 and 12 months but do not correlate with disease duration, the number of relapses, and degree of disability.
多发性硬化症（MS）是一种自身免疫性疾病，其特征是中枢神经系统发生炎症和脱髓鞘，即使只有20%的患者经历视神经炎（ON），视神经也常被累及。
本研究旨在比较MS患者与健康对照者（HCs）的视网膜结构和视神经功能，评估MS患者在1年随访期间的视神经改变，并分析其与疾病持续时间、复发次数、残疾程度及不同亚型的相关性。
这是一项前瞻性队列研究，纳入了58只MS患者的眼睛。采用最佳矫正视力（BCVA）、对比敏感度和P100潜伏期评估视神经功能，同时通过光学相干断层扫描（OCT）和眼底摄影测量黄斑中心凹视网膜神经纤维层（GCIPL）和视网膜神经纤维层（RNFL）厚度来评估视网膜结构。
MS组的BCVA（=0.001）、对比敏感度（<0.001）、平均GCIPL厚度（<0.001）和平均RNFL厚度（<0.001）均低于HC组。在观察的6个月和12个月时，MS患者的GCIPL和RNFL（鼻侧象限）显著减少（分别为=0.007和=0.004）。疾病持续时间和复发次数与P100潜伏期延迟相关（=-0.61，<0.001；=-0.46，=0.02）。继发进展型多发性硬化（SPMS）亚型的GCIPL和RNFL比复发缓解型多发性硬化（RRMS）更薄。
MS患者的视网膜结构和视神经功能比正常个体差。GCIPL和RNFL变薄发生在6个月和12个月，但与疾病持续时间、复发次数和残疾程度无关。
