Neurology:视网膜病变或可揭示多发性硬化进展

2012-12-28 Neurology CMT 银子 编译

           约翰霍普金斯多发性硬化(MS)中心的研究人员近期发表在《神经杂志》上的研究表明:视网膜(眼球视网膜表面的膜)变薄或可揭示多发性硬化的进展情况。      研究人员观察到,MS复发患者比MS未复发的患者视网膜变薄的速度快42%,具体的研究结果如下:钆增强病变(炎性病变)的MS患者视

   眼球
    

   约翰霍普金斯多发性硬化(MS)中心的研究人员近期发表在《神经杂志》上的研究表明:视网膜(眼球视网膜表面的膜)变薄或可揭示多发性硬化的进展情况。
     研究人员观察到,MS复发患者比MS未复发的患者视网膜变薄的速度快42%,具体的研究结果如下:钆增强病变(炎性病变)的MS患者视网膜变薄速度快54%;核磁共振显示,有新T2病变的MS患者比一般MS患者视网膜变薄的速度快36%;研究过程中视网膜变薄速度快37%,受试者的残疾程度就加重;患病5年以内的患者比患病5年以上的患者,视网膜变薄速度快43%。



Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning

Objective

To determine the effect of clinical and radiologic disease activity on the rate of thinning of the ganglion cell/inner plexiform (GCIP) layer and the retinal nerve fiber layer in patients with multiple sclerosis (MS) using optical coherence tomography (OCT).

Methods

One hundred sixty-four patients with MS and 59 healthy controls underwent spectral-domain OCT scans every 6 months for a mean follow-up period of 21.1 months. Baseline and annual contrast-enhanced brain MRIs were performed. Patients who developed optic neuritis during follow-up were excluded from analysis.

Results

Patients with the following features of disease activity during follow-up had faster rates of annualized GCIP thinning: relapses (42% faster, p = 0.007), new gadolinium-enhancing lesions (54% faster, p < 0.001), and new T2 lesions (36% faster, p = 0.02). Annual GCIP thinning was 37% faster in those with disability progression during follow-up, and 43% faster in those with disease duration <5 years vs >5 years (p = 0.003). Annual rates of GCIP thinning were highest in patients exhibiting combinations of new gadolinium-enhancing lesions, new T2 lesions, and disease duration <5 years (70% faster in patients with vs without all 3 characteristics, p < 0.001).

Conclusions
MS patients with clinical and/or radiologic nonocular disease activity, particularly early in the disease course, exhibit accelerated GCIP thinning. Our findings suggest that retinal changes in MS reflect global CNS processes, and that OCT-derived GCIP thickness measures may have utility as an outcome measure for assessing neuroprotective agents, particularly in early, active MS.    

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    2013-03-27 jml2009
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    2013-09-07 yinhl1978
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    2012-12-30 zutt
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