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第一次急性视神经炎的OCT基础区分:111名NMOSD和MOGAD患者的国际研究

Thivya Pakeerathan¹, James Davis², Amanda D Henderson²

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

Neurology(R) neuroimmunology & neuroinflammation

|January 7, 2026

概括

光学连贯性断层扫描 (OCT) 可以快速区分髓寡基细胞糖蛋白抗体相关疾病 (MOGAD) -光学神经炎 (ON) 和神经炎光学谱障碍 (NMOSD) -ON. 这种成像技术有助于早期诊断和治疗视神经炎的决定.

科学领域:

神经眼科神经眼科
神经免疫学神经免疫学
医疗成像医学成像

背景情况:

严重的视神经炎 (ON) 是MOGAD和NMOSD的常见症状.
由于预后和治疗方法不同,迅速区分至关重要,例如为NMOSD进行血交换.

研究的目的:

评估光学连贯断层扫描 (OCT) 在区分急性NMOSD-ON和MOGAD-ON中的实用性.
在这些条件下识别与盘相关的因素.

主要方法:

对111名首次发生ON (MOGAD或AQP4-IgG NMOSD) 的成年患者进行了回顾性多中心研究.
在症状发作后2周内进行了OCT.
周状视网膜神经纤维层 (pRNFL) 厚度的分析.

主要成果:

盘 (pRNFL 加厚>2SD) 在73.4%的MOGAD-ON眼中存在,而在NMOSD-ON眼中则为11.1% (p < 0.001).
一个pRNFL厚度切线为117.5μm,实现了92.9%的特异性和71.1%的分化灵敏度 (AUC = 0.838).
双边的MOGAD-ON显示出更明显的PRNFL结厚.

结论:

在抗体确认之前,急性阶段的OCT对MOGAD-ON和NMOSD-ON之间的快速区分非常有价值.
这可以指导神经炎症视神经病变的关键,及时的治疗决策.

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