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视网膜变性的演变与复发进展性多发性硬化症疾病活动的预测。

Evolution of retinal degeneration and prediction of disease activity in relapsing and progressive multiple sclerosis.

机构信息

Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany.

Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.

出版信息

Nat Commun. 2024 Jun 19;15(1):5243. doi: 10.1038/s41467-024-49309-7.

DOI:10.1038/s41467-024-49309-7
PMID:38897994
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11187157/
Abstract

Retinal optical coherence tomography has been identified as biomarker for disease progression in relapsing-remitting multiple sclerosis (RRMS), while the dynamics of retinal atrophy in progressive MS are less clear. We investigated retinal layer thickness changes in RRMS, primary and secondary progressive MS (PPMS, SPMS), and their prognostic value for disease activity. Here, we analyzed 2651 OCT measurements of 195 RRMS, 87 SPMS, 125 PPMS patients, and 98 controls from five German MS centers after quality control. Peripapillary and macular retinal nerve fiber layer (pRNFL, mRNFL) thickness predicted future relapses in all MS and RRMS patients while mRNFL and ganglion cell-inner plexiform layer (GCIPL) thickness predicted future MRI activity in RRMS (mRNFL, GCIPL) and PPMS (GCIPL). mRNFL thickness predicted future disability progression in PPMS. However, thickness change rates were subject to considerable amounts of measurement variability. In conclusion, retinal degeneration, most pronounced of pRNFL and GCIPL, occurs in all subtypes. Using the current state of technology, longitudinal assessments of retinal thickness may not be suitable on a single patient level.

摘要

视网膜光学相干断层扫描已被确定为复发缓解型多发性硬化症 (RRMS) 疾病进展的生物标志物，而进展型多发性硬化症 (PPMS 和 SPMS) 中视网膜萎缩的动态变化尚不清楚。我们研究了 RRMS、原发性进展型多发性硬化症 (PPMS) 和继发性进展型多发性硬化症 (SPMS) 患者的视网膜层厚度变化及其对疾病活动的预后价值。在这里，我们分析了来自五个德国多发性硬化症中心的 195 名 RRMS、87 名 SPMS、125 名 PPMS 患者和 98 名对照者的 2651 次 OCT 测量结果，在质量控制后进行了分析。在所有多发性硬化症和 RRMS 患者中，视盘周围和黄斑视网膜神经纤维层 (pRNFL、mRNFL) 厚度可预测未来的复发，而在 RRMS（mRNFL、GCIPL）和 PPMS（GCIPL）患者中，mRNFL 和节细胞内丛状层 (GCIPL) 厚度可预测未来的 MRI 活动。mRNFL 厚度可预测 PPMS 的未来残疾进展。然而，厚度变化率受到大量测量变异性的影响。总之，所有亚型均存在明显的视网膜变性，最明显的是 pRNFL 和 GCIPL。在当前技术的基础上，视网膜厚度的纵向评估可能不适合单个患者的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/b1bf9e0670e8/41467_2024_49309_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/602a74c8425c/41467_2024_49309_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/a3b3cb584f1f/41467_2024_49309_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/482532d7abc6/41467_2024_49309_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/f17680430ec0/41467_2024_49309_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/b1bf9e0670e8/41467_2024_49309_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/602a74c8425c/41467_2024_49309_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/a3b3cb584f1f/41467_2024_49309_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/482532d7abc6/41467_2024_49309_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/f17680430ec0/41467_2024_49309_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d79/11187157/b1bf9e0670e8/41467_2024_49309_Fig5_HTML.jpg

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