Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut, Beirut, Lebanon.
Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Ann Clin Transl Neurol. 2024 Sep;11(9):2236-2253. doi: 10.1002/acn3.52165. Epub 2024 Jul 28.
Spectral domain-optical coherence tomography plays a crucial role in the early detection and monitoring of multiple sclerosis (MS) pathophysiology. We aimed to quantify differences in retinal layer measures among different groups of MS and explored different variables that correlate with retinal measures. This study was reported according PRISMA guidelines. A comprehensive search was done across PubMed, Embase, and Google Scholar. The mean difference in thickness of retinal layers and macular volume was assessed. Meta-regression was done to assess the sources of heterogeneity. A total of 100 articles were included in the meta-analyses. The peripapillary retinal nerve fiber layer (pRNFL) thickness significantly decreased in the MSON (MD: -16.44, P < 0.001), MSNON (MD: -6.97, P < 0.001), and PMS (MD: -11.35, P < 0.001) versus HC. The macular RNFL was lower among the MSON (MD: -6.24, P = 0.013) and MSNON (MD: -3.84, P <0.001) versus HC. Macular ganglion cell layer and inner plexiform layer (GCIPL) was thinner among MSON (MD: -14.83, P <0.001), MSNON (MD: -6.38, P < 0.001), and PMS (MD: -11.52, P < 0.001) compared with control eyes. Inner nuclear layer (INL) was higher in the MSON (MD: 0.49, P < 0.001) versus HC. Outer nuclear layer (ONL) thickness significantly lower in the MSNON (MD: -1.15, P = 0.019) versus HC. Meta-regression showed that disease duration, age, EDSS score, and percentage of patients taking DMT are all negatively correlated with pRNFL and GCIPL thickness; however, female gender was correlated with less atrophy. As conclusion, the study highlights substantial thinning in the pRNFL and macular GCIPL between MS versus controls. INL as valuable parameter for capturing inflammatory disease activity.
谱域光学相干断层扫描在多发性硬化症（MS）病理生理学的早期检测和监测中起着至关重要的作用。我们旨在量化不同 MS 组之间视网膜层测量的差异，并探讨与视网膜测量相关的不同变量。本研究按照 PRISMA 指南进行报告。在 PubMed、Embase 和 Google Scholar 上进行了全面搜索。评估了视网膜层厚度和黄斑体积的平均差异。进行了荟萃回归分析，以评估异质性的来源。共有 100 篇文章纳入荟萃分析。结果显示，与 HC 相比，MSON（MD：-16.44，P<0.001）、MSNON（MD：-6.97，P<0.001）和 PMS（MD：-11.35，P<0.001）的视盘周围视网膜神经纤维层（pRNFL）厚度显著降低。MSON（MD：-6.24，P=0.013）和 MSNON（MD：-3.84，P<0.001）的黄斑视网膜神经纤维层较低。MSON（MD：-14.83，P<0.001）、MSNON（MD：-6.38，P<0.001）和 PMS（MD：-11.52，P<0.001）的黄斑神经节细胞层和内丛状层（GCIPL）较薄与对照组相比。与 HC 相比，MSON（MD：0.49，P<0.001）的内核层（INL）较高。MSNON（MD：-1.15，P=0.019）的外核层（ONL）厚度明显低于 HC。荟萃回归显示，疾病持续时间、年龄、EDSS 评分和接受 DMT 的患者比例均与 pRNFL 和 GCIPL 厚度呈负相关；然而，女性与萎缩程度较轻相关。总之，该研究强调了 MS 与对照组之间 pRNFL 和黄斑 GCIPL 明显变薄。INL 是捕捉炎症性疾病活动的有价值参数。
