Pattern of macular thickness changes measured by ocular coherence tomography in patients with multiple sclerosis

BACKGROUND: An analysis of the pattern of retinal thickness changes in macula in patients with multiple sclerosis (MS) was performed. PATIENTS AND METHODS: In fifteen patients with MS retinal thickness measurements in the central (fovea plus inner macular ring) and peripheral (outer ring) macula obtained by ocular coherence tomography (OCT-3 device) were compared to those of 15 age-matched healthy controls. RESULTS: Eyes of MS patients had on the average a thinner macula (241.8 +/- 20.6 micrometers) than control eyes (252.0 +/- 16.4, p value 0.038). Significant segmental differences occurred in the central macula (p = 0.013). Eight eyes with a positive history of optic neuritis (ON) had on average a thinner macula (226.8 +/- 14.0) than eyes of MS patients without a history of ON (non-ON eyes: 247.3 +/- 20.1, p value 0.01). The only measure significantly different between non-ON and control eyes was the ratio between the central and peripheral macular thickness (p = 0.017). Average macular thickness in non-ON eyes, unlike control eyes (r = - 0.63, p = 0.0002), did not correlate with age (r = 0.01, p = 0.97), however, it did show a borderline correlation with disease duration (r = - 0.41, p = 0.056). CONCLUSIONS: Preferential thinning in the central relative to the peripheral macular region is present in eyes of patients with MS. The macular thickness pattern is likely due to the histological distribution of nerve fibre layer and retinal ganglion cell in the macular area and seems to be particularly informative of neurodegeneration in the eyes of MS patients without a history of optic neuritis.     

The relationship between visual field and retinal nerve fiber layer measurements in patients with multiple sclerosis

PURPOSE: To investigate the relationship between visual function, measured by standard automated perimetry (SAP), and retinal nerve fiber layer (RNFL) thickness, measured by optical coherence tomography (OCT), in patients with multiple sclerosis (MS). METHODS: SAP and RNFL thickness were measured in patients with MS in 28 eyes with the last optic neuritis (ON) >or=6 months prior (ON group) and 33 eyes without ON history (non-ON group). Abnormal overall or quadrant RNFL thickness was defined by measured values below 5% of the norm. A whole visual field or a sector of the field was classified as abnormal by using cluster criteria on total-deviation plots. Agreement between SAP and OCT results in classifying eyes/sectors was presented as a percentage of observed agreement, along with the AC1 statistic, which corrects for chance agreement. Regression analyses were performed relating several SAP parameters and RNFL thickness in the ON group. RESULTS: ON eyes showed more loss of visual sensitivity (MD, P = 0.02) and more loss of RNFL thickness (P < 0.0001) than did non-ON eyes. SAP and OCT agreed in 86% (AC1 = 0.78) of eyes and 69% (AC1 = 0.38) of sectors in the ON group and 61% (AC1 = 0.33) of eyes and 66% (AC1 = 0.48) of sectors in the non-ON group. Overall RNFL thickness was related to MD (dB) by a simple exponential function (R(2) = 0.48), supporting a linear relationship between these measures when both are expressed on linear scales. Absolute Pearson correlation coefficients for overall RNFL thickness and several SAP parameters ranged from 0.51 to 0.69. CONCLUSIONS: Good agreement between SAP and OCT was found in ON eyes but not in non-ON eyes or in individual sectors in either group. The findings in this study provide further support for the utility of combining structural and functional testing in clinical research on patients with MS, as well as in future neuroprotection trials for which the anterior visual pathways in patients with MS and optic neuritis may be used as a model.     

Multifocal VEP and OCT in optic neuritis: a topographical study of the structure–function relationship

Purpose To investigate topographical relationship between amplitude of multifocal visual evoked potentials (mfVEP) and retinal nerve fibre layer (RNFL) thickness following acute optic neuritis (ON). Patients and Methods Fifty patients with a clinical diagnosis of acute unilateral ON between 6 and 36 months prior to the study and 25 age-matched controls underwent mfVEP testing (Accumap V 2.1, ObjectiVision Pty Ltd, Sydney, Australia) and OCT imaging (fast RNFL protocol, Stratus™, software version 3.0, Carl Zeiss Meditec, Inc., Dublin, CA). RNFL thickness and mfVEP amplitude were measured for upper, temporal and lower retinal sectors and corresponding areas of the visual field in affected eyes of ON patients and control eyes. Inter-eye asymmetry coefficients for both RNFL thickness and mfVEP amplitude were calculated for each zone, and corresponding coefficients were correlated between each other. Results There was highly significant reduction of RNFL thickness and mean mfVEP amplitude in all three retinal sectors of the affected eye. Largest reduction of RNFL thickness was noticed in temporal sector and of mfVEP amplitude in corresponding central part of the visual field. RNFL thickness correlated highly with amplitude of the mfVEP derived from corresponding areas of the visual field in all three zones. Conclusions We demonstrated strong topographical associations between structural and functional measures of optic nerve integrity in patients with ON.     

Analysis of spectral domain optical coherence tomography measurements in optic neuritis: differences in neuromyelitis optica,multiple sclerosis,isolated optic neuritis and normal healthy controls

Purpose: To compare the retinal layer thickness of eyes with optic neuritis (ON) and that of control eyes and ON eyes with and without neuromyelitis optica (NMO) or multiple sclerosis (MS). Methods: Horizontal and vertical SD‐OCT scans of the fovea were undertaken for 56 patients with ON with and without NMO or MS and for 24 healthy controls. Patients with ON were divided into three groups: NMO, MS and isolated ON without NMO or MS. The thickness of each retinal layer was compared between ON and healthy control eyes, and between ON eyes with and without NMO or MS. Results: Compared with healthy control eyes, ON eyes showed significant thinning of the ganglion cell layer plus the inner plexiform layer (GCL + IPL) at all eight inner and outer macular locations. Significant differences in thickness were observed for the retinal layers of NMO, MS and isolated ON without NMO or MS at several retinal locations. Conclusions: Our SD‐OCT data revealed a notable difference in the GCL + IPL thickness between ON and healthy control eyes. It also showed differences in the thickness of several retinal layers for ON subgroups including NMO, MS and isolated ON. This may be helpful for distinguishing the aetiology of ON.     

Evaluation of retinal nerve fibre layer thickness and visual evoked potentials in optic neuritis associated with multiple sclerosis

Background: The aim was to compare the retinal nerve fibre layer (RNFL) thickness and visual evoked potentials (VEP) among eyes with multiple sclerosis (MS)‐associated optic neuritis, unaffected eyes of the same patients and eyes of disease‐free controls. Changes in RNFL thickness, visual acuity (VA) and VEP over time are evaluated in MS‐associated optic neuritis. Methods: Forty‐six eyes of 23 patients (six male and 17 female), who suffer from MS and were diagnosed with unilateral or bilateral optic neuritis, participated in the study. Forty eyes of 20 age‐ and gender‐matched controls were tested. VA measurement, optical coherence tomography and VEP were performed in all patients at presentation and at one, three and six months thereafter. Results: There was a statistically significant difference in VA between MS eyes with optic neuritis and controls (p < 0.0001), as well as between MS eyes with and without optic neuritis (p < 0.005). VA improved over time. Average RNFL thickness was reduced in MS eyes with or without optic neuritis in comparison to control eyes. This reduction in RNFL thickness was more marked over time. The amplitude of P₁₀₀ was significantly decreased in MS eyes with optic neuritis in comparison to controls (p < 0.0001) and there was a statistically significant delay in peak time of P₁₀₀ in MS eyes with optic neuritis versus the eyes of normal subjects (p < 0.0001), which improved over time. Conclusion: The present study suggests that there is a progressive decrease in RNFL over time in eyes with optic neuritis associated with MS. The amplitude and latency of P₁₀₀ in VEP examination returned to normal ranges over time.     

Electroretinogram findings in unilateral optic neuritis

To report the electrophysiological findings in patients with unilateral optic neuritis (ON), with particular reference to the electroretinogram (ERG). A retrospective analysis of full-field ERG, pattern ERG (PERG) and pattern visual evoked potential findings from 46 patients with clinical and electrophysiological findings in keeping with unilateral ON. ISCEV standard ERGs did not significantly differ between the optic neuritis and fellow eyes, nor between patients with and without MS. Differences were present in the N95 component of the PERG, which was significantly lower in the affected eye, and the pattern reversal visual evoked potential, which showed significantly longer peak time (latency) in the affected eye. In addition, there was a significant difference between patients with and without multiple sclerosis (MS). No significant inter-ocular asymmetry in ISCEV standard ERGs was present in these cases of unilateral optic neuritis, either as a clinically isolated syndrome or as part of multiple sclerosis. All ERGs recorded were normal.     

Mechanism of delayed conduction of fellow eyes in patients with optic neuritis

To test the hypothesis that latency delay in the fellow eyes of optic neuritis (ON) patients and to compensate for delayed transmission of visual information, latency change of multi-focal visual evoked potential (mfVEP) traces in fellow eyes of 15 ON patients were analyzed. Patients with low risk (LR) for developing multiple sclerosis (MS) were examined separately from MS patients to isolate effect of cortical plasticity from potential pathological changes in disseminated disease. The small increase in latency in fellow eyes of LR group was statistically not significant. In MS patients, the latency was significantly delayed (P<0.02). The magnitude of the latency change in the fellow eyes did not correlate with the severity of latency delay in the affected eyes (R2<0.02, P=0.3). The differences between ON patients with and without MS, reported here, suggest that the presence of disseminated disease plays critical role in latency delay of the fellow eye.     

Evaluation of optical coherence tomography angiography findings in patients with multiple sclerosis

Purpose:To evaluate optical coherence tomography angiography findings in patients with multiple sclerosis (MS).Methods:This prospective noninterventional study was conducted on 30 eyes of relapsing-remitting MS patients. Group (1) included 10 eyes with a history of optic neuritis (ON), group (2) included 10 eyes without any history of optic neuritis (MS-ON), and group (3) included 10 eyes of normal age/sex/refraction matched participants. Optical coherence tomography (OCT) and OCT-A (ZEISS Cirrus™ HD-OCT Model 4000 (Carl Zeiss-Meditec, Dublin, CA) of the optic disc were done for all patients.Results:The best-corrected visual acuity was diminished in MS cases, especially in patients with ON with P value <0.001. The retinal nerve fiber layer (RNFL) thickness showed a significant decrease in the average thickness and in all quadrants, notably the temporal quadrant in group 1 (P < 0.001). Ganglion cell layer thickness was diminished in average thickness and in all quadrants in both groups of MS, but only the first group showed statistical significance with P value <0.001). In respect to optic disc perfusion, Average, superficial, and deep vascular density index (AVDI, VDI 1, VDI 2) were statistically significantly lower in groups 1, 2 with (P-value < 0.001).Conclusion:Decreased vascular perfusion of the optic nerve in MS patients, especially in those with ON is strongly correlated with the damage of RNFL and ganglion cell layer detected by OCT.     

A study of retinal parameters measured by optical coherence tomography in patients with multiple sclerosis

AIM: To investigate the difference of retinal nerve fiber layer (RNFL) thickness and macular fovea thickness/volume between multiple sclerosis (MS) patients and healthy normal individuals using optical coherence tomography (OCT) and assess its association with visual field parameters. METHODS: Thirty consecutive MS patients and 28 healthy controls were recruited in this prospective study. Comprehensive standardized ophthalmic examinations included visual acuity, cycloplegic refraction, intraocular pressure, gonioscopy, visual field, and RNFL thickness and macular fovea thickness/volume detection using Humphrey OCT. Mean values for the thickness of the peripapillary RNFL and macular volume were calculated. Associations between visual field parameters and RNFL thickness/macular volume were analyzed by Pearson correlation analysis. RESULTS: The RNFL thicknesses in each quadrant, the average macular thickness, and the average macular volume in MS patients were all less than those in healthy controls, with statistically significant differences. The RNFL thickness and macular fovea thickness/volume were greater in eyes without optic neuritis than in eyes with optic neuritis. The average visual field parameters had positive correlations with the RNFL thickness and negative correlations with macular parameters in MS patients. CONCLUSION: OCT measurements can effectively identify the nerve changes of MS patients, which provide more data for the diagnosis of MS.     

【In Press】 Mechanism of delayed conduction of fellow eyes in patients with optic neuritis

To test the hypothesis that latency delay in the fellow eyes of optic neuritis (ON) patients is to compensate for delayed transmission of visual information, latency change of multi-focal visual evoked potential (VEP) traces in fellow eyes of 15 ON patients were analyzed. Patients with low risk (LR) for developing multiple sclerosis (MS) were examined separately from multiple sclerosis patients to isolate effect of cortical plasticity from potential pathological changes in disseminated disease. The small increase in latency in fellow eyes of LR group was statistically not significant. In MS patients, the latency was significantly delayed (P<0.02). The magnitude of the latency change in the fellow eyes did not correlate with the severity of latency delay in the affected eyes (R2<0.02, P=0.3). The differences between ON patients with and without MS, reported here, suggest that the presence of disseminated disease plays critical role in latency delay of the fellow eye.     

Atrofia de la capa de fibras nerviosas de la retina en pacientes con esclerosis múltiple. Estudio prospectivo con dos años de seguimiento

ObjectiveTo evaluate the changes over two years in the retinal nerve fibre layer (RNFL) of patients with múltiple sclerosis (MS). To compare the ability of optical coherence tomography (OCT), scanning laser polarimetry (GDx), visual evoked potentials (VEP) and visual field examination to detect axonal loss in these patients.Material and methodsFifty eyes of MS patients without episodes or optic neuritis during follow-up were enrolled in this study. All patients underwent a complete ophthalmic examination that included visual acuity (VA), colour vision, refractive evaluation, visual field examination, OCT, GDx and VEP. All the patients were re-evaluated over a period of 12 and 24 months. Correlations between parameters were analysed by Pearson's test.ResultsThere were changes in the RNFL thickness in MS patients with a 12 and 24-month follow-up. Differences between baseline and 2-year evaluation were statistically significant (p ≤ 0.05, t test) in the mean, superior and inferior RNFL thickness and macular volume provided by OCT, while no significant differences were found using functional parameters (VA, colour vision, visual field and VEP) and GDx. The greater differences were obtained in the inferior RNFL thickness (113.67 frente a 105.39 μm, p < 0.001). Correlations were observed between structural parameters using GDx and TCO.ConclusionsProgressive axonal loss can be detected in the optic nerve of MS patients. Measurements provided by TCO are useful tools to evaluate structural abnormalities in the RNFL and changes in macular volume, however these changes were not detected using functional tests or GDx.© 2009 Sociedad Española de Oftalmología. Published by Elsevier España, S.L. All rights reserved.     

Anatomic and functional correlation of frequency-doubling technology perimetry (FDTP) in multiple sclerosis

To study the correlation between the results of frequency-doubling technology perimetry (FDTP), visual function (visual acuity, contrast vision, standard automated perimetry (SAP)) and the thickness of the retinal nerve fiber layer (RNFL) throughout the course of multiple sclerosis (MS). Sixty-six eyes of thirty-three patients suffering from MS were chosen. Thirty-five eyes had a previous history of optic neuritis (ON group) and thirty-one eyes had no previous history of optic neuritis (non-ON group). The FDTP was performed with the N-30 screening program. Visual acuity was determined with the Snellen scale and the ETDRS (Early Treatment Diabetic Retinopathy Study) scale, the contrast vision with the Pelli-Robson and Sloan tests and the SAP with the Humphrey 750 perimeter. The thickness of the RNFL was measured using the STRATUS OCT? optical coherence tomography (OCT). The visual field FDTP was divided into three sectors corresponding to the three SAP sectors and to the three RNFL quadrants of the OCT. The FDTP was significantly correlated (P<0.0001) to the contrast vision and to the SAP results (mean deviation (MD) and the different sectors among themselves). In the ON group, the MD FDTP was significantly correlated to the average RNFL thickness (r=0.44, P=0.0091). A decrease of 5 decibels (dB) of the MD FDTP corresponded to a decrease of 11.7 μm of the average RNFL thickness (Y=2.34×X+87.5). The strong correlation with SAP and RNFL confirms the value of FDTP in assessing optic nerve damage throughout the course of MS.     

Comparison of retinal nerve fibre layer thickness with visual evoked potential and visual field in patients with multiple sclerosis

Background: To evaluate retinal nerve fibre layer thickness and to compare results with visual evoked potentials and visual field in patients with multiple sclerosis. Design: A prospective, case‐control study, university hospital setting. Participants: Seventy‐three eyes of 37 multiple sclerosis patients and 74 eyes of 37 healthy subjects. Methods: All patients underwent a complete neurological and ophthalmological examination and peri‐papillary retinal nerve fibre layer thickness was evaluated using scanning laser polarimetry (GDx). Furthermore, visual evoked potential and visual field testing were performed. Main Outcome Measures: The χ² test, Student's t‐test, Mann–Whitney U‐test and Pearson's correlation coefficient analysis of the GDx, visual evoked potential and visual field testing parameters. Results: GDx measurements showed significantly more retinal nerve fibre layer damage in the patients than in the control groups. Comparison of the GDx parameters between patients with optic neuritis and non‐optic neuritis demonstrated a statistically significant difference in symmetry (P = 0.046) and superior/nasal parameters (P = 0.009). A correlation was found between the number, superior and inferior ratio parameters, and P100 amplitude obtained with visual evoked potential in patients with non‐optic neuritis. Additionally, there was a correlation between the number, inferior ratio and superior/nasal parameters, and the mean deviation of visual field in the non‐optic neuritis group. Conclusions: For retinal nerve fibre layer thickness measurements in multiple sclerosis patients, the GDx, along with other techniques, such as visual evoked potential, can be used as a diagnostic and follow‐up criterion, particularly in patients without optic neuritis.     

Electrophysiological evidence for heterogeneity of lesions in optic neuritis

PURPOSE: To examine the natural history of multifocal visual evoked potentials (mfVEPs) within 12 months of the first episode of optic neuritis (ON) in patients with possible multiple sclerosis (MS). METHODS: Twenty-seven patients with a first episode of ON, no previous demyelinating events, and MRI lesions consistent with demyelination were examined with mfVEP. Changes in amplitude and latency of mfVEP were analyzed at 1, 3, 6, and 12 months after an acute attack. RESULTS: Five of 27 patients had persistent loss of amplitude after 12 months of follow-up. This loss was most marked centrally. Amplitude recovered in the remaining 22 patients at 1 month, but delayed latency, which was also most marked centrally, persisted. Of these, two distinct subgroups were identified: six patients with no improvement in latency and 16 patients with significant latency recovery over the 12 months of follow-up, suggesting remyelination. Conversion to MS was highest in the group with severe amplitude loss, followed by the group with no latency recovery. The conversion rate was lowest in the group of patients with latency improvement. CONCLUSIONS: Distinct patterns of disease evolution were identified using mfVEP in patients with first episode of optic neuritis and at high risk for MS, supporting the concept of heterogeneity of early lesions in MS.     

Contrast sensitivity in multiple sclerosis. A study in 35 patients with and without optic neuritis

Binocular and monocular contrast sensitivity (CS) functions were determined for 35 patients with multiple sclerosis (MS) of whom only 21 had a history of optic neuritis. CS was abnormal in all 21 of these patients; alterations of CS affected all spatial frequencies, not only for the eye with optic neuritis, but also for the clinically unaffected eye (p less than 0.01). Approximately one third of the 14 patients with MS but without any history of past visual disturbances showed an optic nerve involvement. Our results show that (1) clinically visual impairment is bilateral, even if optic neuritis seems unilateral, and (2) CS can detect silent lesions of the visual pathways in MS and may prove to be more sensitive than visual evoked potentials.     

Structural-visual functional relationships detected by optical coherence tomography in varying age-cohorts’ patients with optic neuritis

AIM: To assess the relationships of final best-corrected visual acuity (BCVA) and the optic nerve structural loss in varying age-cohorts of optic neuritis (ON) patients. METHODS: This is a retrospective, cross-sectional study. Totally 130 ON subjects (200 eyes) without ON onset within 6mo were included, who underwent BCVA assessment, peripapillary retinal nerve fibre layer (pRNFL) and macular segmented layers evaluation by optical coherence tomography (OCT). RESULTS: For the 0-18y cohort, the final BCVA (logMAR) was significantly better and less frequent recurrences than adult cohorts (P=0.000). The final BCVA (logMAR) in all age-cohorts of the ON patients had negative and linear correlations to the pRNFL thicknesses and macular retinal ganglion cell layer (mRGCL) volumes, when the pRNFL thicknesses were reduced to the thresholds of 57.2-67.5 µm or 0.691-0.737 mm3 in mRGCL volumes, respectively, with the strongest interdependence in the 19-40y cohort. The ON patients from varying age cohorts would be threatened by blindness when their pRNFL thicknesses dropped 36.7-48.3 µm or the mRGCL volumes dropped to 0.495-0.613 mm3. CONCLUSION: The paediatric ON has best prognosis and young adult ON exhibits perfectly linear correlations of final vision and structural loss. The pRNFL and the mRGCL could be potential structural markers to predict the vision prognosis for varying-age ON patients.     

Quantification of optic nerve head topography in optic neuritis: a pilot study

AIMS: To investigate optic nerve head topography in patients with optic neuritis compared to controls using the Heidelberg retina tomograph-II (HRT-II) and to determine if detected changes are related to visual function and electrophysiology. METHODS: 25 patients with a previous single episode of unilateral optic neuritis and 15 controls were studied with HRT-II, visual evoked potentials, and pattern electroretinogram. Patients also had testing of visual acuity, visual field, and colour vision. RESULTS: In affected eyes compared to fellow eyes, there was reduction of both the mean retinal nerve fibre layer (RNFL) thickness at the disc edge (p = 0.009) and the neuroretinal rim volume (p = 0.04). In affected eyes compared to control eyes, the three dimensional optic cup shape measure was increased (p = 0.01), indicative of an abnormal cup shape. There were no other significant differences in HRT-II measures. Within patient interocular difference correlation was used to investigate the functional relevance of these changes and demonstrated associations between RNFL thickness change and changes in visual acuity, visual field, and colour vision. Colour vision change was also associated with change in neuroretinal rim volume. CONCLUSIONS: HRT detects functionally relevant changes in RNFL thickness and neuroretinal rim volume between eyes affected by optic neuritis and unaffected fellow eyes.     

Visual function and inner retinal structure correlations in aquaporin-4 antibody-positive optic neuritis

Purpose

To investigate the correlation between visual function and thinning of the retinal nerve fiber layer (RNFL) and the macular ganglion cell-inner plexiform layer (GCIPL) as measured by optical coherence tomography (OCT) in eyes with aquaporin-4 IgG-positive optic neuritis (AQP4-IgG-positive ON).

Study design

Prospective study.

Methods

Patients with a history of ON were categorized into 2 groups: the AQP4-IgG-positive group and the AQP4-IgG-negative group. Patients with multiple sclerosis were excluded. All patients underwent ophthalmologic examination and OCT imaging at least 6 months after the last episode of acute ON. Visual function and inner retinal structure correlations were analyzed using Pearson correlation and regression analyses.

Results

Thirty-one previous ON eyes of 17 AQP4-IgG-positive patients and 21 previous ON eyes of 15 AQP4-IgG-negative patients were registered. Visual function, especially the visual field, was better correlated with RNFL than with macular GCIPL. The best correlation between visual function and RNFL was the linear model, whereas the best correlation between visual function and GCIPL was the nonlinear model (inverse regression). Regression models revealed worse visual function in AQP4-IgG-positive ON than in AQP4-IgG-negative ON, whereas no differences in RNFL and GCIPL were found between the 2 groups.

Conclusions

RNFL measured by OCT can be a useful retinal structure for estimating and monitoring visual field loss in AQP4-IgG-positive ON patients, particularly in patients whose visual field cannot be quantitated. The correlation between visual function and the inner retinal structure of eyes with AQP4-IgG is unique and differs from that of eyes without AQP4-IgG.

     

VEP and PERG in patients with multiple sclerosis,with and without a history of optic neuritis

Purpose

Visual electrophysiology is routinely used to detect the visual complications of multiple sclerosis, but the analysis mostly focuses on visual evoked potential (VEP) and especially the P100 component. Our goal was to analyze the components and waveform alterations of VEPs and pattern electroretinograms (PERGs) in patients with multiple sclerosis (MS) with good vision.

Methods

The main VEP and PERG components of 85 patients with MS were analyzed in two groups: 38 patients who had optic neuritis in their history (ON group) and 47 patients who had never had optic neuritis (MS group). The results were compared against a control group of 47 healthy subjects.

Results

Both VEP and PERG alterations occurred in a greater number of patients than expected, and these alterations were not necessarily linked to ON in the history or a deterioration of visual acuity.

Conclusions

Both VEP and PERG can detect dysfunction in the visual system in MS, even if the patient has no subjective symptoms. Even if PERG is not routinely used in neuro-ophthalmology, the results suggest that PERG assessment may provide useful information describing the retinal defect in MS.

     

视神经炎的临床特征分析及早期视盘和黄斑的改变

目的　研究视神经炎患者的临床特征及早期视盘和黄斑的改变。方法　回顾性分析山西省眼科医院视神经炎患者67例85眼。分析患者基本情况、眼科检查结果及OCT检查结果。结果　67例85眼中，男24例，女43例；28例（41.8%）发生于冬季；49眼（57.6%）入院时最佳矫正视力小于1.7 logMAR。视神经脊髓炎抗体阳性者出院和入院时的最佳矫正视力均较髓鞘少突胶质糖蛋白抗体阳性者差。患眼较健眼视盘周围神经纤维层增厚，杯盘面积比、杯盘垂直比、杯盘水平比、杯容积减小，盘沿面积、视盘面积增大（均为P=0.000）；与健眼相比，患眼早期上方、下方和平均黄斑区神经节细胞层厚度及黄斑区神经节细胞复合体的局部丢失体积、整体丢失体积均未发生明显改变（均为P＞0.05）。视盘水肿与患眼平均视盘周围神经纤维层厚度存在正相关（r=0.728，P=0.000）。结论　视神经炎多发生于女性，早期视力损害严重，视神经脊髓炎抗体阳性者视力预后差。早期由于视盘水肿，视盘周围神经纤维层增厚，盘沿面积、视盘面积增大；杯容积、杯盘比减小，早期病变未累及黄斑区。