在多发性硬化症中,视网膜神经元损失和进展独立于复发活动
Federico Burguet Villena1,2,3,4,5, Nuria Cerdá-Fuertes1,2,3,4,6, Lisa Hofer2
1Department of Neurology, University Hospital Basel, Basel, Switzerland.
Journal of neurology
|June 10, 2025
概括
光学连贯断层扫描 (OCT) 揭示了视网膜内部稀释作为多发性硬化症 (MS) 进展的关键指标. 这项研究将视网膜神经纤维层和质细胞层的稀薄与MS患者的复发活动 (PIRA) 独立的进展联系起来.
科学领域:
- 神经眼科神经眼科
- 神经退行性疾病的神经退行性疾病
- 医学成像医学成像
背景情况:
- 内视网膜变薄,可通过光学连贯断层扫描 (OCT) 测量,与多发性硬化症 (MS) 中的大脑病变和灰质变化相关.
- 了解MS的进展标志物对于患者管理和治疗策略至关重要.
研究的目的:
- 调查特定的OCT衍生的视网膜层厚度与MS中独立于复发活动的进展 (PIRA) 之间的关联.
- 为了确定视网膜层薄化是否预测PIRA和PIRMA (没有MRI活动的PIRA).
主要方法:
- 来自瑞士多发性硬化症队列研究的数据分析,包括至少有一次OCT扫描的患者.
- 测量周状视网膜神经纤维层 (pRNFL),黄斑结节细胞内部状层 (mGCIPL) 和内部核层 (mINL) 的厚度.
- 使用线性回归模型来评估视网膜层与PIRA/PIRMA率之间的关联,并根据相关共变量进行调整.
主要成果:
- 每十年每次PIRA事件都与pRNFL和mGCIPL厚度的显著下降有关.
- 虽然mINL厚度与PIRA没有显著的关联,但所有三种OCT措施 (pRNFL,mGCIPL,mINL) 都与PIRMA有显著的关联.
- 该研究包括171名患者,平均随访时间为8.1年;39%的患者经历了PIRA.
结论:
- 视网膜变薄,特别是在pRNFL和mGCIPL中,作为预测MS患者进展的敏感生物标志物.
- 国外和海外的测量为MS的亚临床疾病进展提供了宝贵的见解,即使没有临床复发或MRI活动.
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