Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Mult Scler. 2024 May;30(6):674-686. doi: 10.1177/13524585241240420. Epub 2024 Apr 22.
Optic neuritis (ON) is a common feature of inflammatory demyelinating diseases (IDDs) such as multiple sclerosis (MS), aquaporin 4-antibody neuromyelitis optica spectrum disorder (AQP4 + NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). However, the involvement of the optic chiasm (OC) in IDD has not been fully investigated.
To examine OC differences in non-acute IDD patients with (ON+) and without ON (ON-) using magnetisation transfer ratio (MTR), to compare differences between MS, AQP4 + NMOSD and MOGAD and understand their associations with other neuro-ophthalmological markers.
Twenty-eight relapsing-remitting multiple sclerosis (RRMS), 24 AQP4 + NMOSD, 28 MOGAD patients and 32 healthy controls (HCs) underwent clinical evaluation, MRI and optical coherence tomography (OCT) scan. Multivariable linear regression models were applied.
ON + IDD patients showed lower OC MTR than HCs (28.87 ± 4.58 vs 31.65 ± 4.93; = 0.004). When compared with HCs, lower OC MTR was found in ON + AQP4 + NMOSD (28.55 ± 4.18 vs 31.65 ± 4.93; = 0.020) and MOGAD (28.73 ± 4.99 vs 31.65 ± 4.93; = 0.007) and in ON- AQP4 + NMOSD (28.37 ± 7.27 vs 31.65 ± 4.93; = 0.035). ON+ RRMS had lower MTR than ON- RRMS (28.87 ± 4.58 vs 30.99 ± 4.76; = 0.038). Lower OC MTR was associated with higher number of ON (regression coefficient (RC) = -1.15, 95% confidence interval (CI) = -1.819 to -0.490, = 0.001), worse visual acuity (RC = -0.026, 95% CI = -0.041 to -0.011, = 0.001) and lower peripapillary retinal nerve fibre layer (pRNFL) thickness (RC = 1.129, 95% CI = 0.199 to 2.059, = 0.018) when considering the whole IDD group.
OC microstructural damage indicates prior ON in IDD and is linked to reduced vision and thinner pRNFL.
视神经炎（ON）是多发性硬化症（MS）、水通道蛋白 4 抗体相关视神经脊髓炎谱系疾病（AQP4+NMOSD）和髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）等炎症性脱髓鞘疾病（IDD）的常见特征。然而，视神经交叉（OC）在 IDD 中的参与尚未得到充分研究。
使用磁化传递率（MTR）检查非急性期 IDD 患者伴（ON+）和不伴 ON（ON-）的 OC 差异，比较 MS、AQP4+NMOSD 和 MOGAD 之间的差异，并了解它们与其他神经眼科标志物的关系。
28 例复发缓解型多发性硬化症（RRMS）、24 例 AQP4+NMOSD、28 例 MOGAD 患者和 32 名健康对照者（HCs）接受了临床评估、MRI 和光学相干断层扫描（OCT）检查。应用多变量线性回归模型。
ON+IDD 患者的 OC MTR 低于 HCs（28.87±4.58 比 31.65±4.93；=0.004）。与 HCs 相比，ON+AQP4+NMOSD（28.55±4.18 比 31.65±4.93；=0.020）和 MOGAD（28.73±4.99 比 31.65±4.93；=0.007）患者的 OC MTR 更低，ON-AQP4+NMOSD 患者的 OC MTR 也更低（28.37±7.27 比 31.65±4.93；=0.035）。ON+RRMS 的 MTR 低于 ON-RRMS（28.87±4.58 比 30.99±4.76；=0.038）。较低的 OC MTR 与更多的 ON 次数（回归系数（RC）=-1.15，95%置信区间（CI）=-1.819 至-0.490，=0.001）、更差的视力（RC=-0.026，95%CI=-0.041 至-0.011，=0.001）和更薄的视盘周围视网膜神经纤维层（pRNFL）厚度（RC=1.129，95%CI=0.199 至 2.059，=0.018）相关，当考虑整个 IDD 组时。
OC 微观结构损伤表明 IDD 中存在先前的 ON，并与视力下降和 pRNFL 变薄有关。
