Guantay Carla D, Mena-García Laura, Tola-Arribas Miguel Ángel, Garea García-Malvar María José, Yugueros Fernández María Isabel, Mayo-Iscar Agustín, Pastor José Carlos
Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain.
Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, Spain.
Eye Brain. 2024 Nov 12;16:89-100. doi: 10.2147/EB.S469182. eCollection 2024.
To characterize ocular motility disturbances through Microperimetry (MP) in patients with Multiple Sclerosis (MS) trying to detect those capable of influencing the disability to improve the accuracy of assessing visual impact in EDSS scale. MP results were compare with some structural parameters obtained by OCT.
Cross-sectional analytical and correlational case-control study approved by Ethical Committee. A total of 82 eyes (41 patients) and 30 healthy eyes (15 subjects) were enrolled after informed consent. All participants underwent ophthalmological evaluation with MP and OCT. Variables included MS disease duration, Expanded Disability Status Scale (EDSS) score; in OCT: central macular thickness (CMT), ganglion cell-inner plexiform layer thickness (GCIPL), and peripapillary retinal nerve fiber layer thickness (pRNFL); and in MP: test duration, reaction time, average macular threshold (AT), and 4 fixation stability indexes (P1, P2, BCEA63, BCEA95).
MS group showed a significant decrease in GCIPL (p < 0.001) and pRNFL thickness (p < 0.001) compared to the control group. Furthermore, patients demonstrated a longer examination (p < 0.001) and reaction (p < 0.001) times, reduced AT (p < 0.001), more unstable fixation indexes (P1 p <0.004, P2 p = 0.018, BCEA63 p = 0.005 and BCEA95 p = 0.007), measured by MP. In addition, patients with a history of ON (n=16) demonstrated longer examination times in MP (p = 0.049) compared to MS patients without ON, but they were not correlations with OCT measurements, EDSS score correlated with the CMT (p = 0.023, r = -0.25), MP duration (p = 0.043, r = 0.22), and fixation indexes (P1 p = 0.049, r = -0.22, BCEA63 p = 0.041, r = 0.23, BCEA95 p = 0.049, r = 0.22).
Our study emphasizes the complementary utility of MP and OCT in assessing MS patients. Additionally, it highlights that using MP for objective measurements of oculomotor dysfunction could improves accuracy in disability assessment on the EDSS scale.
通过微视野计(MP)对多发性硬化症(MS)患者的眼球运动障碍进行特征分析,试图检测出那些能够影响残疾程度的因素,以提高在扩展残疾状态量表(EDSS)中评估视觉影响的准确性。将MP结果与光学相干断层扫描(OCT)获得的一些结构参数进行比较。
本横断面分析和相关性病例对照研究经伦理委员会批准。在获得知情同意后,共纳入82只眼睛(41例患者)和30只健康眼睛(15名受试者)。所有参与者均接受了MP和OCT眼科评估。变量包括MS病程、扩展残疾状态量表(EDSS)评分;在OCT方面:中心黄斑厚度(CMT)、神经节细胞-内丛状层厚度(GCIPL)和视乳头周围视网膜神经纤维层厚度(pRNFL);在MP方面:检查持续时间、反应时间、平均黄斑阈值(AT)以及4个注视稳定性指标(P1、P2、BCEA63、BCEA95)。
与对照组相比,MS组的GCIPL(p < 0.001)和pRNFL厚度(p < 0.001)显著降低。此外,患者表现出更长的检查时间(p < 0.001)和反应时间(p < 0.001),AT降低(p < 0.001),通过MP测量的注视稳定性指标更不稳定(P1 p <0.004,P2 p = 0.018,BCEA63 p = 0.005,BCEA95 p = 0.007)。此外,有视神经炎(ON)病史的患者(n = 16)在MP中的检查时间比没有ON的MS患者更长(p = 0.049),但它们与OCT测量值无相关性,EDSS评分与CMT(p = 0.023,r = -0.25)、MP持续时间(p = 0.043,r = 0.22)和注视指标(P1 p = 0.049,r = -0.22,BCEA63 p = 0.041,r = 0.23,BCEA95 p =
0.049,r = 0.22)相关。
我们的研究强调了MP和OCT在评估MS患者方面的互补作用。此外,研究突出了使用MP客观测量眼球运动功能障碍可提高EDSS量表中残疾评估的准确性。