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神经纤维光链水平区分缺血和炎症性视神经病变

Shailee Shah¹, Sara Mariotto², Eoin P Flanagan³

¹Department of Neurology, Northwestern University, Chicago, Il, USA; Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, USA.

Multiple sclerosis and related disorders

|October 1, 2025

概括

血清神经纤维光链 (sNfL) 水平可以帮助区分非动脉炎前部缺血性视觉神经病变 (NAION) 和视觉神经炎 (ON) 在水素-4 (AQP4) -IgG阳性神经omyelitis光谱障碍 (NMOSD) 和髓寡聚细胞糖蛋白抗体相关疾病 (MOGAD). 较高的sNfL水平与较差的视觉结果相关.

科学领域:

眼科医生眼科眼科
神经学神经学
生物标志物研究生物标志物研究

背景情况:

血清神经丝光链 (sNfL) 是神经轴损伤的潜在生物标志物.
从临床上来说,区分非动脉炎前部缺血性视觉神经病变 (NAION) 和视觉神经炎 (ON) 是非常重要的.
ON可能与自身免疫性疾病有关,如水素-4 (AQP4) -IgG阳性神经omyelitis光学谱障碍 (NMOSD) 和髓寡基细胞蛋白抗体相关疾病 (MOGAD).

研究的目的:

评估sNfL在区分NAION与AQP4-IgG+NMOSD和MOGAD相关的ON方面的歧视能力.
评估急性发作期间的sNfL水平与随后的视觉结果之间的相关性.

主要方法:

在患有急性视神经病变 (NAION,AQP4-IgG+NMOSD ON,MOGAD ON) 和健康对照患者中测量了sNfL水平.
进行了统计分析,以比较不同组的sNfL水平,并评估与视力敏度的相关性.

主要成果:

在所有患者队列和对照组之间观察到sNfL水平的显著差异 (p < 0.001).
与ON相比,NAION中的sNfL水平显著更高 (p < 0.001).
对于sNfL的60 pg/mL值显示在区分NAION和ON时具有很高的特异性 (100%) (AUC=0.82).
与最终视力敏度相关的sNfL水平,独立于视神经病变的病因 (R2 = 0.49,p < 0.001).

结论:

sNfL水平显示出作为生物标志物的潜力,可以区分NAION与AQP4-IgG+NMOSD和MOGAD相关的ON.
在患有视神经病变的患者中,sNfL水平可以作为长期视觉预后的预测指标.
建议使用标准化的z-score进行进一步的研究,以获得可靠的临床解释.

关键词:

亚波林-4是一种亚波林-4 在MOG抗体中.莫加德 - 莫加德这是NMOSD的NMOSD.视神经炎是一种视神经炎.视觉神经病变视觉神经病变视觉神经病变

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