急性视神经炎患者的视敏度下降可能与视网膜有关。

IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Documenta Ophthalmologica Pub Date : 2022-12-01 DOI:10.1007/s10633-022-09896-6
I Kleerekooper, L Del Porto, L Dell'Arti, J Guajardo, S Leo, A G Robson, S A Trip, A Petzold, G T Plant, G E Holder
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引用次数: 1

摘要

目的:视神经炎(ON)的黄斑受累是公认的,但知之甚少,可能具有临床相关性。本研究探讨急性ON的黄斑结构-功能相关性。方法:本横断面队列研究招募症状出现14天内的ON患者。实验对象接受了视网膜电图(PERG)、视觉诱发电位(PVEP)和光学相干断层扫描(OCT)成像。PERG P50和N95成分与OCT数据相关。结果:招募了26例ON患者,包括11例多发性硬化症(MS-ON), 6例髓鞘少突胶质细胞糖蛋白相关(MOG-ON)和9例分离性ON。这些人与28名健康对照进行了比较。11例(42%)ON患者未检测到pvep。当检测到PVEP P100时,与对照组相比,ON的PVEP P100延迟(中位数136 ms,范围110 ~ 173 ms),幅度降低(中位数6 μV,范围3 ~ 14 μV) (p均= 0.36;p = 0.009)和黄斑神经节细胞及内丛状层(mGCIPL)厚度(rs = 0.44, p = 0.022)。结论:PERG P50组分的降低揭示了急性ON的黄斑内层功能障碍,并与oct的结构改变有关,这些早期黄斑病理过程可能导致视力丧失。
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Pattern ERGs suggest a possible retinal contribution to the visual acuity loss in acute optic neuritis.

Purpose: Macular involvement in optic neuritis (ON) is well-recognised but poorly understood and may be of clinical relevance. This study explores macular structure-function correlates in acute ON.

Methods: This cross-sectional cohort study recruited ON patients within 14 days of symptom onset. Subjects underwent pattern electroretinography (PERG), pattern visual evoked potentials (PVEP) and optical coherence tomography (OCT) imaging. PERG P50 and N95 components were correlated with OCT data.

Results: Twenty-six individuals with ON were recruited, comprising eleven multiple sclerosis (MS-ON), six myelin oligodendrocyte glycoprotein associated (MOG-ON) and nine with isolated ON. These were compared with 28 healthy controls. PVEPs were undetectable in 11 (42%) of individuals with ON. When detectable, PVEP P100 was delayed (median 136 ms range 110-173 ms) and amplitude reduced (median 6 μV, range 3-14 μV) in ON compared with controls (both p < 0.001). PERG P50 component amplitudes, largely reflecting macular function, were reduced in affected eyes (median 2.3 μV; range 0.8-5.0 μV) compared with controls (3.3 μV; range 2.8-5.7 μV) and compared with fellow eyes (p < 0.001). The N95:P50 ratio was below the reference range in the affected eyes of five patients. Eight cases (32%) had subnormal P50 amplitudes (< 2.0 μV), and these patients had poorer visual acuity (p = 0.020). P50 amplitudes were positively correlated with an increase in inner nuclear layer thickness (rs = 0.36; p = 0.009) and macular ganglion cell and inner plexiform layer (mGCIPL) thickness (rs = 0.44, p = 0.022).

Conclusion: PERG P50 component reduction reveals dysfunction of inner macular layers in acute ON and correlates with structural alterations on OCT. These early macular pathologic processes are likely to contribute to the visual loss.

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来源期刊
Documenta Ophthalmologica
Documenta Ophthalmologica 医学-眼科学
CiteScore
3.50
自引率
21.40%
发文量
46
审稿时长
>12 weeks
期刊介绍: Documenta Ophthalmologica is an official publication of the International Society for Clinical Electrophysiology of Vision. The purpose of the journal is to promote the understanding and application of clinical electrophysiology of vision. Documenta Ophthalmologica will publish reviews, research articles, technical notes, brief reports and case studies which inform the readers about basic and clinical sciences related to visual electrodiagnosis and means to improve diagnosis and clinical management of patients using visual electrophysiology. Studies may involve animals or humans. In either case appropriate care must be taken to follow the Declaration of Helsinki for human subject or appropriate humane standards of animal care (e.g., the ARVO standards on Animal Care and Use).
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