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在单次视神经炎后,MOGAD和MS的快速分化

T Pakeerathan¹, J Havla², C Schwake¹

¹Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.

Journal of neurology

|September 9, 2024

概括

光学连贯性断层扫描 (OCT) 可以区分与多发性硬化症 (MS) 发生光神经炎 (ON) 后的多发性硬化症 (MOGAD) 相关的髓 - 寡 dendrocyte - 糖蛋白IgG疾病. 与MS相比,MOGAD显示出更多的全球视网膜神经纤维层缩和较低的视力敏度.

科学领域:

神经眼科神经眼科
神经免疫学神经免疫学
医学成像医学成像

背景情况:

视神经炎 (ON) 是多发性硬化症 (MS) 和髓-寡基细胞-糖蛋白IgG相关疾病 (MOGAD) 的常见症状.
区分MOGAD和MS对于适当的治疗和预后至关重要.
光学连贯断层扫描 (OCT) 是一种非侵入性成像技术,可视化视网膜神经纤维层 (RNFL).

研究的目的:

评估OCT在区分MOGAD和MS的有效性,在患有ON病史的患者中.
开发和验证使用OCT参数和临床数据的复合得分,以区分MOGAD和MS.

主要方法:

招募了两个独立的ON患者队列 (MOGAD和MS).
标准的OCT和高对比度视敏度 (HCVA) 测试在ON.ON后至少六个月进行.
使用多变量逻辑回归来开发基于OCT发现和临床表现的复合得分.

主要成果:

与多发性硬化症患者相比,MOGAD患者在所有细分体中表现出更频繁的双边ON和更大的周周细胞RNFL (pRNFL) 缩.
多发性硬化症患者通常有更好的视力敏度和主要是时间PRNFL缩.
开发的基于OCT的复合得分在初级队列中实现了75%的灵敏度和90%的特异性,在区分MOGAD和MS方面取得了相似的表现,并在验证队列中取得了类似的表现.

结论:

与MS相比,MOGAD与更严重的全球PRNFL缩和ON后较差的视觉结果有关.
来自OCT的综合评分有效地区分了MOGAD和MS,有助于临床诊断.

关键词:

多发性硬化症是多发性硬化症.髓寡细胞糖蛋白IgG相关疾病.骨髓 - - 基基细胞 - - 糖蛋白 IgG 视神经炎是一种视神经炎.光学连贯性断层扫描技术.视觉唤起了潜在的潜力.

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