Department of Neuroscience DNS, School of Medicine, University of Padua, Via Giustiniani, 5, 35128, Padua, Veneto Region, Italy.
Multiple Sclerosis Centre, University Hospital of Padua, Padua, Veneto Region, Italy.
J Neurol. 2022 Oct;269(10):5436-5442. doi: 10.1007/s00415-022-11183-y. Epub 2022 Jun 1.
Ocrelizumab was found to decrease brain atrophy rate in primary progressive multiple sclerosis (PPMS), but no data are currently available on the effect of ocrelizumab on retinal layer thicknesses in the PPMS population.
To assess retinal layer changes in ocrelizumab-treated PPMS and test their possible application as biomarkers of therapy response.
36 PPMS patients, treated with ocrelizumab for at least 6 months, and 39 sex- and age-matched healthy controls (HC) were included in a blind, longitudinal study. Spectrum-domain optical coherence tomography (SD-OCT) was performed at study entry (T0) and after 6 (T6) and 12 months (T12). At month 24 (T24), patients were divided into responders (no evidence of 1-year confirmed disability progression, 1y-CDP) and non-responders (evidence of 1y-CDP).
At T24, 23/36 (64%) patients were considered responders and 13/36 (36%) non-responders. At T0, peripapillary retinal nerve fiber layer (pRNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) and inner retinal layer (IRL) volume were significantly lower in PPMS compared to HC (p = 0.001 for all comparisons). At T6 and T12, non-responders significantly differed in the inner nuclear layer (INL) thinning rate compared to responders (p = 0.005 at both time-points).
Ocrelizumab significantly slows down INL thinning rate in PPMS responders. The longitudinal analysis of retina layer changes by means of OCT may be a promising prognostic test, and merits further investigations.
奥瑞珠单抗可降低原发性进展型多发性硬化症（PPMS）患者的脑萎缩率，但目前尚无奥瑞珠单抗对 PPMS 人群视网膜层厚度影响的数据。
评估奥瑞珠单抗治疗的 PPMS 患者的视网膜层变化，并检验其作为治疗反应生物标志物的可能应用。
36 名接受奥瑞珠单抗治疗至少 6 个月的 PPMS 患者和 39 名性别和年龄匹配的健康对照者（HC）纳入本盲法、纵向研究。在研究入组时（T0）和 6 个月（T6）和 12 个月（T12）后进行频域光学相干断层扫描（SD-OCT）。在第 24 个月（T24）时，根据是否存在 1 年确认的残疾进展（1y-CDP）将患者分为应答者（无 1y-CDP）和非应答者（有 1y-CDP）。
在 T24 时，23/36（64%）名患者被认为是应答者，13/36（36%）名患者是非应答者。T0 时，与 HC 相比，PPMS 患者的视盘周围视网膜神经纤维层（pRNFL）厚度、黄斑神经节细胞-内丛状层（GCIPL）和内视网膜层（IRL）容积显著降低（所有比较均 p = 0.001）。在 T6 和 T12 时，与应答者相比，非应答者的内核层（INL）变薄率显著不同（在两个时间点均 p = 0.005）。
奥瑞珠单抗可显著减缓 PPMS 应答者的 INL 变薄率。通过 OCT 对视网膜层变化进行的纵向分析可能是一种很有前途的预后检测方法，值得进一步研究。
