在渐进的多发性硬化症中,光学连贯性断层扫描血管学的潜力
Jonathan A Gernert1,2, Hanna Zausinger1, Luca Diedrich1
1Institute of Clinical Neuroimmunology, LMU Hospital, Ludwig-Maximilians-Universität München, 81377, Munich, Germany.
Journal of neurology
|February 7, 2026
概括
光学连贯断层扫描血管造影 (OCTA) 可以检测视网膜血管变化在渐进性多发性硬化症 (PMS). 这种方法可能有助于监测MS (PwMS) 患者的神经退行,并可能成为常规临床实践的一部分.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 在多发性硬化症患者 (PwMS) 中早期发现神经退行过程仍然是一个重大的临床挑战.
- 光学连贯断层扫描血管学 (OCTA) 是一种新兴的非侵入性成像技术,用于可视化视网膜血管.
- 现有的OCTA对多发性硬化症的研究主要集中在复发性形式上,对渐进性多发性硬化症 (PMS) 的研究有限.
研究的目的:
- 评估OCTA作为补充诊断工具的实用性,用于检测和监测进展性多发性硬化症 (PMS) 患者的神经退行症.
- 为了比较PMS患者的视网膜血管密度与年龄和性别匹配的健康对照 (HC).
主要方法:
- 一个单一的,回顾性,横截面研究,涉及62个PwPMS和43个HC.
- 视神经炎的眼睛的排除.
- 使用基于深度学习的细分算法对OCTA图像进行分析,以量化表面血管复合体 (VD_SVC) 中的血管密度.
主要成果:
- 与HC相比,PwPMS观察到减少的VD_SVC (p=0.018).与HC相比,PwPMS观察到减少的VD_SVC (p=0.018).
- 在PwPMS和HC中,VD_SVC与年龄负相关.
- 在较年轻的PwPMS (<57.5年) 中,疾病持续时间影响了VD_SVC.
- 患病持续时间较长 (>10年) 的PwPMS与持续时间较短 (≤5年,p=0.049) 的PwPMS相比,显示VD_SVC减少.
- 在PwPMS中,临床残疾 (EDSS) 与VD_SVC负相关 (β=-0.487,p=0.010).
结论:
- 在PwPMS中,OCTA显示出检测视网膜血管变化的潜力,这表明它可能在监测疾病进展中的作用.
- 结构化和协调的OCTA调查可以整合到PwMS的常规临床实践中.
- 需要进一步的外部验证和纵向研究,以充分确定OCTA在PMS监测中的作用.
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