Huang Lele, Wang Yujie, Zhang Ruijun
Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjingbei Street, Heping District, Shenyang, 110001, People's Republic of China.
Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China.
J Neurol. 2023 Feb;270(2):759-768. doi: 10.1007/s00415-022-11482-4. Epub 2022 Nov 10.
Retina thickness has been studied in patients with neuromyelitis optica spectrum disorders (NMOSD) without distinguishing serostatus and limited data are available in unaffected eyes. We aimed to investigate retina thickness in eyes of aquaporin-4 immunoglobulin G antibody seropositive (AQP4-IgG) NMOSD patients with optic neuritis (AQP4-ON) and without (AQP4-NON).
Eligible studies were identified by searching PubMed and Embase. Mean difference (MD, μm) with corresponding 95% confidence interval (CI) was pooled with random-effect models. The primary measures were average thickness of peripapillar retinal nerve fiber layer (pRNFL) centered on optic disc and the combination of ganglion cell layer and inner plexiform layer (GCIPL) at macula.
We included 21 studies enrolling 787 AQP4-IgG NMOSD patients. Compared with healthy control, pRNFL was thinner in eyes of AQP4-ON (- 32.78, 95% CI [- 36.24, - 29.33]) and AQP4-NON (- 2.76, 95% CI [- 3.94, - 1.58]), so was GICPL in AQP4-ON (-21.38, 95% CI [- 24.01, - 18.74]) and AQP4-NON (95% CI - 2.96, [- 3.91, - 2.00]). Compared with multiple sclerosis with ON, AQP4-ON had thinner pRNFL (- 13.56, 95%CI [- 16.51, - 10.60]) and GCIPL (- 9.12, 95% CI [- 11.88, - 6.36]). AQP4-ON and myelin oligodendrocyte glycoprotein antibody-associated demyelination with ON (MOG-ON) had similar pRNFL (0.59, 95% CI [- 6.61, 7.79]) and GCIPL thickness (- 0.55, 95% CI [- 2.92, 1.82]). AQP4-NON had similar pRNFL and GCIPL thickness to MOG-NON and multiple sclerosis without ON.
The average thickness of pRNFL and GICPL decreased both in AQP4-ON and AQP4-NON eyes. AQP4-ON eyes had a similar level of pRNFL and GICPL thinning to MOG-ON eyes, so did AQP4-NON to MOG-NON eyes.
视神经脊髓炎谱系障碍（NMOSD）患者的视网膜厚度已得到研究，但未区分血清学状态，且未受影响眼睛的数据有限。我们旨在研究水通道蛋白4免疫球蛋白G抗体血清阳性（AQP4-IgG）的视神经炎（AQP4-ON）和无视神经炎（AQP4-NON）的NMOSD患者眼睛的视网膜厚度。
通过检索PubMed和Embase确定符合条件的研究。采用随机效应模型汇总平均差异（MD，μm）及相应的95%置信区间（CI）。主要测量指标是以视盘为中心的视网膜乳头周围神经纤维层（pRNFL）的平均厚度，以及黄斑处神经节细胞层和内网状层（GCIPL）的组合厚度。
我们纳入了21项研究，共787例AQP4-IgG NMOSD患者。与健康对照相比，AQP4-ON患者眼睛的pRNFL更薄（-32.78，95%CI[-36.24，-29.33]），AQP4-NON患者眼睛的pRNFL也更薄（-2.76，95%CI[-3.94，-1.58]）；AQP4-ON患者眼睛的GICPL也更薄（-21.38，95%CI[-24.01，-18.74]），AQP4-NON患者眼睛的GICPL同样更薄（95%CI-2.96，[-3.91，-2.00]）。与伴有视神经炎的多发性硬化症相比，AQP4-ON患者眼睛的pRNFL更薄（-13.56，95%CI[-16.51，-10.60]），GCIPL也更薄（-9.12，95%CI[-11.88，-6.36]）。AQP4-ON与髓鞘少突胶质细胞糖蛋白抗体相关脱髓鞘伴视神经炎（MOG-ON）患者眼睛的pRNFL厚度相似（0.59，95%CI[-6.61，7.79]），GCIPL厚度也相似（-0.55，95%CI[-2.92，1.82]）。AQP4-NON患者眼睛的pRNFL和GCIPL厚度与MOG-NON以及无视神经炎的多发性硬化症患者相似。
AQP4-ON和AQP4-NON患者眼睛的pRNFL和GICPL平均厚度均降低。AQP4-ON患者眼睛的pRNFL和GICPL变薄程度与MOG-ON患者眼睛相似，AQP4-NON患者眼睛与MOG-NON患者眼睛也相似。
