From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
Neurol Neuroimmunol Neuroinflamm. 2021 Oct 19;9(1). doi: 10.1212/NXI.0000000000001099. Print 2022 Jan.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease primarily affecting the peripheral nervous system. However, several noncontrolled studies have suggested concomitant inflammatory CNS demyelination similar to multiple sclerosis. The aim of this study was to investigate an involvement of the visual pathway in patients with CIDP.
In this prospective cross-sectional study, we used high-resolution spectral-domain optical coherence tomography to compare the thickness of the peripapillary retinal nerve fiber layer and the deeper macular retinal layers as well as the total macular volume (TMV) in 22 patients with CIDP and 22 age-matched and sex-matched healthy control (HC) individuals. Retinal layers were semiautomatically segmented by the provided software and were correlated with clinical measures and nerve conduction studies.
In patients with CIDP compared with healthy age-matched and sex-matched controls, we found slight but significant volume reductions of the ganglion cell/inner plexiform layer complex (CIDP 1.86 vs HC 1.95 mm, = 0.015), the retinal pigment epithelium (CIDP 0.38 vs HC 0.40 mm, = 0.02), and the TMV (CIDP 8.48 vs HC 8.75 mm, = 0.018). The ganglion cell layer volume and motor nerve conduction velocity were positively associated (B = 0.002, = 0.02).
Our data reveal subtle retinal neurodegeneration in patients with CIDP, providing evidence for visual pathway involvement, detectable by OCT. The results need corroboration in independent, larger cohorts.
慢性炎症性脱髓鞘性多发性神经病（CIDP）是一种主要影响周围神经系统的自身免疫性疾病。然而，几项非对照研究表明，类似于多发性硬化症，CIDP 患者存在并发的中枢炎症性脱髓鞘。本研究旨在探讨 CIDP 患者视觉通路的受累情况。
在这项前瞻性横断面研究中，我们使用高分辨率谱域光学相干断层扫描（OCT）比较了 22 例 CIDP 患者和 22 名年龄和性别匹配的健康对照（HC）个体的视盘周围视网膜神经纤维层（RNFL）和深层黄斑视网膜层的厚度以及总黄斑体积（TMV）。通过提供的软件半自动分割视网膜层，并与临床测量和神经传导研究相关联。
与健康年龄和性别匹配的对照组相比，CIDP 患者的神经节细胞/内丛状层复合体（GC/IPL）体积（CIDP 1.86 vs HC 1.95 mm， = 0.015）、视网膜色素上皮（RPE）（CIDP 0.38 vs HC 0.40 mm， = 0.02）和 TMV（CIDP 8.48 vs HC 8.75 mm， = 0.018）均有轻微但显著的减少。神经节细胞层体积与运动神经传导速度呈正相关（B = 0.002， = 0.02）。
我们的数据显示 CIDP 患者存在轻微的视网膜神经退行性变，通过 OCT 检测到视觉通路受累的证据。这些结果需要在独立的更大队列中得到证实。
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