使用OCT评估多发性硬化症分期及其严重性（英文）
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摘要
目的:评估光学相干层析成像(OCT)、多发性硬化病程(MS)和扩展伤残状态等级(EDSS)之间的联系。方法:前瞻性双盲研究。29例多发性硬化症确诊患者与29例正常人进行比较,年龄和性别匹配。所有受试者于同一天进行光学相干层析成像检查和神经扩展伤残状态等级测试。结果:多发性硬化症患者平均扩展伤残状态等级指数为3. 2,健康对照组为0. 03,多发性硬化症患者病程为11. 7a。多发性硬化症患者视网膜神经纤维层(RNFL)厚度显著较薄(P<0. 01)。多发性硬化病程与视网膜神经纤维层变薄之间存在相关性。扩展伤残状态等级与视网膜神经纤维层变薄之间呈相关趋势但无统计学意义。结论:较正常对照组,多发性硬化症患者RNFL较薄。多发性硬化症病程对RNFL厚度有直接影响。RNFL厚度与扩展伤残状态等级之间可能存在相关性。建议使用OCT作为多发性硬化症患者的检测和评估工具。
AIM: To identify a link between optical coherence tomography( OCT),length of multiple sclerosis( MS)and the expanded disability status scale( EDSS).METHODS: In a prospective double blind study, 29 patients with a diagnosis of MS were compared with 29 healthy patients,matched by age and sex. All participants underwent an OCT study and neurological EDSS test on the same day.RESULTS: The mean EDSS score was 3. 2 in the MS group vs 0. 03 in the control group,and the duration of MS was 11. 7 y. The mean retinal nerve fiber layer( RNFL)thickness was significantly thinner in those with MS( P<0. 001). Correlation was found between duration of MS and RNFL thinning. EDSS and thinning of RNFL showed a tendency to correlate but without statistical significance.CONCLUSION: RNFL is thinner in MS patients than in the general population. MS duration has a direct statistically significant effect on RNFL thickness. There seems to be a tendency of a relationship between RNFL thinning and EDSS. OCT is suggested as a monitoring and evaluation tool of MS patients.
AIM: To identify a link between optical coherence tomography( OCT),length of multiple sclerosis( MS)and the expanded disability status scale( EDSS).METHODS: In a prospective double blind study, 29 patients with a diagnosis of MS were compared with 29 healthy patients,matched by age and sex. All participants underwent an OCT study and neurological EDSS test on the same day.RESULTS: The mean EDSS score was 3. 2 in the MS group vs 0. 03 in the control group,and the duration of MS was 11. 7 y. The mean retinal nerve fiber layer( RNFL)thickness was significantly thinner in those with MS( P<0. 001). Correlation was found between duration of MS and RNFL thinning. EDSS and thinning of RNFL showed a tendency to correlate but without statistical significance.CONCLUSION: RNFL is thinner in MS patients than in the general population. MS duration has a direct statistically significant effect on RNFL thickness. There seems to be a tendency of a relationship between RNFL thinning and EDSS. OCT is suggested as a monitoring and evaluation tool of MS patients.
引文
1 Saidha S,Syc SB,Ibrahim MA,Eckstein C,Warner CV,Farrell SK,Oakley JD,Durbin MK,Meyer SA,Balcer LJ,Frohman EM,Rosenzweig JM,Newsome SD,Ratchford JN,Nguyen QD,Calabresi PA.Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography.Brain 2011;134(Pt 2):518-533
2 Horakova D,Kalincik T,Dusankova JB,Dolezal O.Clinical correlates of grey matter pathology in multiple sclerosis.BMC Neurol 2012;12:10
3 Ruffoli R,Biagioni F,Busceti CL,Gaglione A,Ryskalin L,Gambardella S,Frati A,Fornai F.Neurons other than motor neurons in motor neuron disease.Histol Histopathol 2017;32(11):1115-1123
4 de Wit NM,Vanmol J,Kamermans A,Hendriks J,de Vries HE.Inflammation at the blood-brain barrier:The role of liver X receptors.Neurobiol Dis 2017;107:57-65
5 Rovira A,Auger C,Alonso J.Magnetic resonance monitoring of lesion evolution in multiple sclerosis.Ther Adv Neurol Disord 2013;6(5):298-310
6 Kurtzke JF.On the origin of EDSS.Mult Scler Relat Disord 2015;4(2):95-103
7 Kurtzke JF.Rating neurologic impairment in multiple sclerosis:an expanded disability status scale(EDSS).Neurology 1983;33(11):1444-1452
8 Britze J,Frederiksen JL.Optical coherence tomography in multiple sclerosis.Eye(Lond)2018;32(5):884-888
9 Barkhof F.MRI in multiple sclerosis:correlation with expanded disability status scale(EDSS).Mult Scler 1999;5(4):283-286
10 Talebi M,Nikanfar M,Sorkhabi R,Sharifipour E,Bahrebar M,Kiavar A,Andalib S,Khanli HM.Optic coherence tomography findings in relapsing-remitting multiple sclerosis patients of the northwest of Iran.Iran J Neurol 2013;12(3):81-86
11 Khanifar AA,Parlitsis GJ,Ehrlich JR,Aaker GD,D'Amico DJ,Gauthier SA,Kiss S.Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography.Clinical Ophthalmology(Auckland,NZ)2010;4:1007-1013
12 Meyer-Moock S,Feng YS,Maeurer M,Dippel FW,Kohlmann T.Systematic literature review and validity evaluation of the expanded disability status scale(EDSS)and the multiple sclerosis functional composite(MSFC)in patients with multiple sclerosis.BMC Neurol2014;14:58
13 Cao H,Peyrodie L,Boudet S,Cavillon F,Agnani O,Hautecoeur P,DonzéC.Expanded disability status scale(EDSS)estimation in multiple sclerosis from posturographic data.Gait Posture 2013;37(2):242-245
14 Bin Sawad A,Seoane-Vazquez E,Rodriguez-Monguio R,Turkistani F.Evaluation of the expanded disability status scale and the multiple sclerosis functional composite as clinical endpoints in multiple sclerosis clinical trials:quantitative Meta-analyses.Curr Med Res Opin 2016;32(12):1969-1974
15 Rudick RA,Polman CH,Cohen JA,Walton MK,Miller AE,Confavreux C,Lublin FD,Hutchinson M,O'Connor PW,Schwid SR,Balcer LJ,Lynn F,Panzara MA,Sandrock AW.Assessing disability progression with the multiple sclerosis functional composite.Mult Scler2009;15(8):984-997
16 Rabadi MH,Vincent AS.Comparison of the Kurtkze expanded disability status scale and the functional independence measure:measures of multiple sclerosis-related disability.Disabil Rehabil 2013;35(22):1877-1884
17 Goldman MD,Motl RW,Rudick RA.Possible clinical outcome measures for clinical trials in patients with multiple sclerosis.Ther Adv Neurol Disord 2010;3(4):229-239
18 Petzold A,de Boer JF,Schippling S,Vermersch P,Kardon R,Green A,Calabresi PA,Polman C.Optical coherence tomography in multiple sclerosis:a systematic review and Meta-analysis.Lancet Neurol2010;9(9):921-932
19 Sriram P,Wang C,Yiannikas C,Garrick R,Barnett M,Parratt J,Graham SL,Arvind H,Klistorner A.Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients.PLoS One 2014;9(8):e102546
20 Kimbrough DJ,Sotirchos ES,Wilson JA,Al-Louzi O,Conger A,Conger D,Frohman TC,Saidha S,Green AJ,Frohman EM,Balcer LJ,Calabresi PA.Retinal damage and vision loss in African American multiple sclerosis patients.Ann Neurol 2015;77(2):228-236
21 Balk LJ,Cruz-Herranz A,Albrecht P,Arnow S,Gelfand JM,Tewarie P,Killestein J,Uitdehaag BM,Petzold A,Green AJ.Timing of retinal neuronal and axonal loss in MS:a longitudinal OCT study.JNeurol 2016;263(7):1323-1331
2 Horakova D,Kalincik T,Dusankova JB,Dolezal O.Clinical correlates of grey matter pathology in multiple sclerosis.BMC Neurol 2012;12:10
3 Ruffoli R,Biagioni F,Busceti CL,Gaglione A,Ryskalin L,Gambardella S,Frati A,Fornai F.Neurons other than motor neurons in motor neuron disease.Histol Histopathol 2017;32(11):1115-1123
4 de Wit NM,Vanmol J,Kamermans A,Hendriks J,de Vries HE.Inflammation at the blood-brain barrier:The role of liver X receptors.Neurobiol Dis 2017;107:57-65
5 Rovira A,Auger C,Alonso J.Magnetic resonance monitoring of lesion evolution in multiple sclerosis.Ther Adv Neurol Disord 2013;6(5):298-310
6 Kurtzke JF.On the origin of EDSS.Mult Scler Relat Disord 2015;4(2):95-103
7 Kurtzke JF.Rating neurologic impairment in multiple sclerosis:an expanded disability status scale(EDSS).Neurology 1983;33(11):1444-1452
8 Britze J,Frederiksen JL.Optical coherence tomography in multiple sclerosis.Eye(Lond)2018;32(5):884-888
9 Barkhof F.MRI in multiple sclerosis:correlation with expanded disability status scale(EDSS).Mult Scler 1999;5(4):283-286
10 Talebi M,Nikanfar M,Sorkhabi R,Sharifipour E,Bahrebar M,Kiavar A,Andalib S,Khanli HM.Optic coherence tomography findings in relapsing-remitting multiple sclerosis patients of the northwest of Iran.Iran J Neurol 2013;12(3):81-86
11 Khanifar AA,Parlitsis GJ,Ehrlich JR,Aaker GD,D'Amico DJ,Gauthier SA,Kiss S.Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography.Clinical Ophthalmology(Auckland,NZ)2010;4:1007-1013
12 Meyer-Moock S,Feng YS,Maeurer M,Dippel FW,Kohlmann T.Systematic literature review and validity evaluation of the expanded disability status scale(EDSS)and the multiple sclerosis functional composite(MSFC)in patients with multiple sclerosis.BMC Neurol2014;14:58
13 Cao H,Peyrodie L,Boudet S,Cavillon F,Agnani O,Hautecoeur P,DonzéC.Expanded disability status scale(EDSS)estimation in multiple sclerosis from posturographic data.Gait Posture 2013;37(2):242-245
14 Bin Sawad A,Seoane-Vazquez E,Rodriguez-Monguio R,Turkistani F.Evaluation of the expanded disability status scale and the multiple sclerosis functional composite as clinical endpoints in multiple sclerosis clinical trials:quantitative Meta-analyses.Curr Med Res Opin 2016;32(12):1969-1974
15 Rudick RA,Polman CH,Cohen JA,Walton MK,Miller AE,Confavreux C,Lublin FD,Hutchinson M,O'Connor PW,Schwid SR,Balcer LJ,Lynn F,Panzara MA,Sandrock AW.Assessing disability progression with the multiple sclerosis functional composite.Mult Scler2009;15(8):984-997
16 Rabadi MH,Vincent AS.Comparison of the Kurtkze expanded disability status scale and the functional independence measure:measures of multiple sclerosis-related disability.Disabil Rehabil 2013;35(22):1877-1884
17 Goldman MD,Motl RW,Rudick RA.Possible clinical outcome measures for clinical trials in patients with multiple sclerosis.Ther Adv Neurol Disord 2010;3(4):229-239
18 Petzold A,de Boer JF,Schippling S,Vermersch P,Kardon R,Green A,Calabresi PA,Polman C.Optical coherence tomography in multiple sclerosis:a systematic review and Meta-analysis.Lancet Neurol2010;9(9):921-932
19 Sriram P,Wang C,Yiannikas C,Garrick R,Barnett M,Parratt J,Graham SL,Arvind H,Klistorner A.Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients.PLoS One 2014;9(8):e102546
20 Kimbrough DJ,Sotirchos ES,Wilson JA,Al-Louzi O,Conger A,Conger D,Frohman TC,Saidha S,Green AJ,Frohman EM,Balcer LJ,Calabresi PA.Retinal damage and vision loss in African American multiple sclerosis patients.Ann Neurol 2015;77(2):228-236
21 Balk LJ,Cruz-Herranz A,Albrecht P,Arnow S,Gelfand JM,Tewarie P,Killestein J,Uitdehaag BM,Petzold A,Green AJ.Timing of retinal neuronal and axonal loss in MS:a longitudinal OCT study.JNeurol 2016;263(7):1323-1331