使用OCT评估多发性硬化症分期及其严重性

OCT as a monitoring tool for assessment of the stage and severity of multiple sclerosis

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。

Abstract:

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 11.7y. 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.