Shchukina T V, Bisaga G N, Malko V A, Tolochko K A, Topuzova M P, Dadatsky A Yu, Efimtsev A Yu, Lepekhina A S, Turchinskaya I A, Alekseeva T M
Almazov National Medical Research Center, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(7. Vyp. 2):66-72. doi: 10.17116/jnevro202512507266.
To search and study the relationship between the change in the thickness of the retinal ganglionic complex layers and the volumetric indicators of the brain in patients with multiple sclerosis (MS).
Fifty-seven MS patients aged 19 to 68 years (mean age 39.6±11.2 years) were examined with a diagnosis confirmed by the 2017 McDonald criteria and no previous history of optic neuritis. All patients underwent MRI brain morphometry, optical coherence tomography (OCT) of the retina, and an Expand Disability Status Scale (EDSS) assessment.
A direct correlation was found between the thickness of most layers of the "internal" retina and the total volume of white and gray matter of the telencephalon, nuclei accumbens, pallidum, ventral diencephalon, superior parietal gyrus, thalamus, and inversely with the size of the ventricular system of the brain, subcallosal zone, total volume of cerebrospinal fluid (CSF), and foci of brain lesion. The transverse size of the ganglion cell layer (GCL) correlated most with the volumetric parameters of the brain: with the volumes of gray (=0.426; =0.001) and white (=0.564; <0.000) matter, the nucleus accumbens (=0.841; <0.000), thalamus (=0.542; =0.000), CSF (=-0.601; <0.000), and cingulate gyrus (=0.304; =0.002). A less distinct correlation was found between the brain parameters and the thickness of the ganglion cell layer and the inner plexiform layer (GCIPL) with volumes of gray (=0.389; 0.002) and white (=0.439; 0.000) matter, nucleus accumbens (=0.463; 0.000), thalamus (=0.447; 0.000), CSF (=-0.518; 0.000), cerebellum (=0.331; 0.012), and peripapillary retinal nerve fiber layer (pRNFL) with volumes of white matter (=0.419; 0.001), nucleus accumbens (=0.421; 0.001), thalamus (=0.396; 0.002), CSF (=-0.368; 0.004), and hippocampus (=0.399; 0.002). A significant positive correlation was found between the thickness of the macular retinal nerve fiber layer (mRNFL) and cerebellar volumetric parameters (=0.351; 0.007).
The anatomical and pathological structure of the eye's retina reflects the neurodegeneration of the central nervous system as a whole. The most sensitive markers of regional gray matter atrophy of the brain are macular thickness in GCL and GCIPL, as well as pRNFL.
探究和研究多发性硬化症（MS）患者视网膜神经节复合体层厚度变化与脑容量指标之间的关系。
对57例年龄在19至68岁（平均年龄39.6±11.2岁）的MS患者进行检查，其诊断依据2017年麦克唐纳标准确定，且既往无视神经炎病史。所有患者均接受了脑部MRI形态测量、视网膜光学相干断层扫描（OCT）以及扩展残疾状态量表（EDSS）评估。
发现“内层”视网膜大多数层的厚度与端脑、伏隔核、苍白球、腹侧间脑、顶上回、丘脑的白质和灰质总体积呈正相关，与脑室系统大小、胼胝体下区、脑脊液（CSF）总体积以及脑病变灶呈负相关。神经节细胞层（GCL）的横向尺寸与脑容量参数的相关性最强：与灰质（=0.426；=0.001）和白质（=0.564；<0.000）体积、伏隔核（=0.841；<0.000）、丘脑（=0.542；=0.000）、脑脊液（=-0.601；<0.000）以及扣带回（=0.304；=0.002）相关。在脑参数与神经节细胞层和内丛状层（GCIPL）厚度之间发现的相关性较弱，这些层与灰质（=0.389；0.002）和白质（=0.439；0.000）体积、伏隔核（=0.463；0.000）、丘脑（=0.447；0.000）、脑脊液（=-0.518；0.000）、小脑（=0.331；0.012）以及视乳头周围视网膜神经纤维层（pRNFL）与白质（=0.419；0.001）、伏隔核（=0.421；0.001）、丘脑（=0.396；0.002）、脑脊液（=-0.368；0.004）以及海马体（=0.399；0.002）相关。在黄斑视网膜神经纤维层（mRNFL）厚度与小脑容量参数之间发现显著正相关（=0.351；0.007）。
眼睛视网膜的解剖和病理结构反映了整个中枢神经系统的神经退行性变。脑局部灰质萎缩最敏感的标志物是GCL和GCIPL中的黄斑厚度以及pRNFL。
