Fursova A Zh, Zubkova M Yu, Vasilyeva M A, Karlash Yu A, Derbeneva A S
Novosibirsk State Regional Hospital, Novosibirsk, Russia.
Novosibirsk State Medical University, Novosibirsk, Russia.
Vestn Oftalmol. 2024;140(2):63-70. doi: 10.17116/oftalma202414002163.
This study analyzes the main changes in retinal microcirculation in patients with multiple sclerosis (MS) and their relationship with the type of disease course.
159 patients (318 eyes) were examined. The groups were formed according to the type of course and duration of MS: group 1 - 37 patients (74 eyes; 23.27%) with relapsing-remitting MS (RRMS) less than 1 year; group 2 - 47 patients (94 eyes; 29.56%) with RRMS from 1 year to 10 years; group 3 - 44 patients (86 eyes; 27.05%) with RRMS >10 years; group 4 - 32 patients (64 eyes; 20.12%) with secondary progressive MS (SPMS). Subgroups A and B were allocated within each group depending on the absence or presence of optic neuritis (ON). Patients underwent standard ophthalmological examination, including optical coherence tomography angiography (OCTA).
A decrease in the vessel density (wiVD) and perfusion density (wiPD) in the macular and peripapillary regions was revealed, progressing with the duration of the disease and with its transition to the progressive type. The minimum values were observed in patients with SPMS (group 4), with the most pronounced in the subgroup with ON (wiVD = 16.06±3.65 mm/mm, wiPD = 39.38±9.46%, ppwiPD = 44.06±3.09%, ppwiF = 0.41±0.05).
OCTA provides the ability to detect subclinical vascular changes and can be considered a comprehensive, reliable method for early diagnosis and monitoring of MS progression.
本研究分析了多发性硬化症（MS）患者视网膜微循环的主要变化及其与病程类型的关系。
对159例患者（318只眼）进行了检查。根据MS的病程类型和持续时间分组：第1组 - 37例患者（74只眼；23.27%），复发缓解型MS（RRMS）病程小于1年；第2组 - 47例患者（94只眼；29.56%），RRMS病程1年至10年；第3组 - 44例患者（86只眼；27.05%），RRMS病程>10年；第4组 - 32例患者（64只眼；20.12%），继发进展型MS（SPMS）。根据是否存在视神经炎（ON）在每组内分为A、B亚组。患者接受了包括光学相干断层扫描血管造影（OCTA）在内的标准眼科检查。
发现黄斑和视乳头周围区域的血管密度（wiVD）和灌注密度（wiPD）降低，且随着病程延长及其向进展型转变而加重。SPMS患者（第4组）中观察到最低值，在伴有ON的亚组中最为明显（wiVD = 16.06±3.65 mm/mm，wiPD = 39.38±9.46%，ppwiPD = 44.06±3.09%，ppwiF = 0.41±0.05）。
OCTA能够检测亚临床血管变化，可被视为MS早期诊断和病情监测的一种全面、可靠的方法。
