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光学相干断层扫描在中枢免疫介导性脱髓鞘疾病患者中的应用——一项前瞻性研究。

Utility of optical coherence tomography in patients of central immune mediated demyelinating diseases - A prospective study.

作者信息

Vegda Monalisa, Panda Samhita, Bhatnagar Kavita R

机构信息

DM Neurology, All India Institute of Medical Sciences, Jodhpur, India.

DM Neurology, Department of Neurology, All India Institute of Medical Sciences, Jodhpur, India.

出版信息

eNeurologicalSci. 2023 Apr 15;31:100464. doi: 10.1016/j.ensci.2023.100464. eCollection 2023 Jun.

Abstract

Optical coherence tomography (OCT) is a non-invasive tool to measure thickness of various layers of retina. Recently, retinal nerve fibre layer (RNFL) and ganglion cell and inner plexiform layer (GCIP) thinning has been observed in OCT in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), This study compared OCT profile, along with visual acuity (VA), color vision (CV), contrast saturation (CS) and visual evoked potentials (VEP) in two main cohorts of MS and NMOSD and with controls, during acute episode of optic neuritis (ON), at 3 and 6 months. We found that changes of ON were present in 75% of MS eyes and in 45% of NMOSD patients. Of these, subclinical involvement was present in 56.25% of MS eyes and only in 5% of NMOSD eyes suggesting frequent subclinical involvement in the former. Mean RNFL was 95.23 ± 15.53 in MS and 66.14 ± 43.73 in NMOSD after 6 months of ON episode. Thinning of NQ and IQ was observed in NMOSD eyes in the immediate period after ON attack. At 6 months relative sparing of RNFL in TQ was observed in NMOSD ON eyes and MS ON showed predilection for involvement of TQ.

摘要

光学相干断层扫描(OCT)是一种用于测量视网膜各层厚度的非侵入性工具。最近,在多发性硬化症(MS)和视神经脊髓炎谱系障碍(NMOSD)患者的OCT检查中观察到视网膜神经纤维层(RNFL)以及神经节细胞和内丛状层(GCIP)变薄。本研究比较了MS和NMOSD两个主要队列以及对照组在视神经炎(ON)急性发作期、3个月和6个月时的OCT特征,同时还比较了视力(VA)、色觉(CV)、对比敏感度(CS)和视觉诱发电位(VEP)。我们发现,75%的MS患眼和45%的NMOSD患者存在ON改变。其中,56.25%的MS患眼存在亚临床受累,而NMOSD患眼中仅5%存在亚临床受累,这表明前者亚临床受累更为常见。ON发作6个月后,MS患者的平均RNFL为95.23±15.53,NMOSD患者为66.14±43.73。在ON发作后的急性期,NMOSD患眼中观察到NQ和IQ变薄。6个月时,在NMOSD的ON患眼中观察到TQ的RNFL相对保留,而MS的ON患眼则倾向于TQ受累。

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