在复发性多发性硬化症中监测疾病修饰性治疗的视网膜层稀释 - - 应用重新基线化概念的证据
Gabriel Bsteh1, Harald Hegen2, Nik Krajnc1
1Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
概括
在复发性多发性硬化症 (RMS) 患者的光学连贯性断层扫描 (OCT) 数据的重新定位减少了噪音. 这种方法通过排除先前的疾病活动,更好地区分疾病修饰治疗 (DMT) 对视网膜层稀释的影响.
科学领域:
- 眼科医生 眼科 眼科
- 神经科学是一个神经科学.
- 医疗成像医学成像
背景情况:
- 视网膜层稀薄是多发性硬化症 (MS) 进展的一个关键指标.
- 光学连贯断层扫描 (OCT) 用于测量这些变化.
- 以往疾病活动的噪音可能会混测量.
研究的目的:
- 评估重新基线化概念在减少OCT测量的视网膜层稀释中的噪声中的实用性.
- 改善疾病修饰治疗 (DMT) 对视网膜神经退行症的影响的差异化.
主要方法:
- 对173名复发性多发性硬化症 (RMS) 患者进行前性观察性研究.
- 在基线,再基线 (6-12个月) 和随访时获得了OCT扫描.
- 从基线和再基线计算,计算了周状视网膜神经纤维层 (pRNFL) 和黄斑结节细胞内状层 (GCIPL) 的年均损失率.
- 混合效应线性回归模型用于分析.
主要成果:
- 在恢复基线之前,视网膜层稀疏 (pRNFL和GCIPL) 随着复发和残疾恶化显著增加.
- 在使用重新基线测量时没有观察到这些关联.
- 高效的DMT (HE-DMT) 显著减少了PRNFL和GCIPL稀释,相比于在重新基础化后的中度有效的DMT (M-DMT).
结论:
- 重新调整CTN的测量有效地将以前疾病活动的混降到最低.
- 这种方法提高了识别DMT对RMS视网膜层稀释的真实影响的能力.
- 重生是MS临床试验和实践中精确评估神经退行的一个有价值的工具.
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