视网膜光学相干断层成像:多发性硬化症的生物标志物?

IF 3.1 Q1 OPHTHALMOLOGY Eye and Brain Pub Date : 2018-07-31 eCollection Date: 2018-01-01 DOI:10.2147/EB.S139417
Fiona Costello, Jodie M Burton
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引用次数: 58

摘要

多发性硬化症(MS)是一种进行性神经系统疾病,以炎症和退行性成分为特征,影响遗传易感个体。目前,多发性硬化症的病因尚不清楚,也没有已知的治疗方法。常用的治疗方法倾向于针对MS的炎症方面,但可能无法阻止疾病进展,这可能是由中枢神经系统(CNS)神经轴突结构损伤的缓慢、亚临床积累所控制的。MS领域的一个公认的挑战是需要更好的方法来检测、量化和改善亚临床疾病的影响。简单地说,需要更好的生物标志物。为此,光学相干断层扫描(OCT)为多发性硬化症患者的轴突损伤和神经元丢失提供了高度可靠、可重复的测量方法。oct检测到的视网膜神经纤维层厚度和神经节-细胞层-内丛状层厚度的减少,分别代表轴突损伤和神经元损伤的标志,已被证明与MS患者更差的视觉结果、临床残疾增加和磁共振成像测量的疾病负担相关。最近的报道也表明oct测量的微囊性黄斑水肿和相关的视网膜内核层增厚是中枢神经系统炎症活动活跃的标志。使用视觉系统作为MS的假定临床模型,OCT测量神经轴突结构可以与功能结果相关联,从而帮助我们阐明中枢神经系统损伤和修复的机制。在这篇综述中,我们评估了来自已发表文献和正在进行的临床试验的证据,这些证据支持OCT在MS患者的诊断、分期和确定治疗反应方面的新作用。
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Retinal imaging with optical coherence tomography: a biomarker in multiple sclerosis?

Multiple sclerosis (MS) is a progressive neurological disorder characterized by both inflammatory and degenerative components that affect genetically susceptible individuals. Currently, the cause of MS remains unclear, and there is no known cure. Commonly used therapies tend to target inflammatory aspects of MS, but may not halt disease progression, which may be governed by the slow, subclinical accumulation of injury to neuroaxonal structures in the central nervous system (CNS). A recognized challenge in the field of MS relates to the need for better methods of detecting, quantifying, and ameliorating the effects of subclinical disease. Simply stated, better biomarkers are required. To this end, optical coherence tomography (OCT) provides highly reliable, reproducible measures of axonal damage and neuronal loss in MS patients. OCT-detected decrements in retinal nerve fiber layer thickness and ganglion-cell layer-inner plexiform layer thickness, which represent markers of axonal damage and neuronal injury, respectively, have been shown to correlate with worse visual outcomes, increased clinical disability, and magnetic resonance imaging-measured burden of disease in MS patients. Recent reports have also suggested that OCT-measured microcystic macular edema and associated thickening of the retinal inner nuclear layer represent markers of active CNS inflammatory activity. Using the visual system as a putative clinical model in MS, OCT measures of neuroaxonal structure can be correlated with functional outcomes to help us elucidate mechanisms of CNS injury and repair. In this review, we evaluate evidence from the published literature and ongoing clinical trials that support the emerging role of OCT in diagnosing, staging, and determining response to therapy in MS patients.

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来源期刊
Eye and Brain
Eye and Brain OPHTHALMOLOGY-
CiteScore
7.90
自引率
2.30%
发文量
12
审稿时长
16 weeks
期刊介绍: Eye and Brain is an international, peer-reviewed, open access journal focusing on basic research, clinical findings, and expert reviews in the field of visual science and neuro-ophthalmology. The journal’s unique focus is the link between two well-known visual centres, the eye and the brain, with an emphasis on the importance of such connections. All aspects of clinical and especially basic research on the visual system are addressed within the journal as well as significant future directions in vision research and therapeutic measures. This unique journal focuses on neurological aspects of vision – both physiological and pathological. The scope of the journal spans from the cornea to the associational visual cortex and all the visual centers in between. Topics range from basic biological mechanisms to therapeutic treatment, from simple organisms to humans, and utilizing techniques from molecular biology to behavior. The journal especially welcomes primary research articles or review papers that make the connection between the eye and the brain. Specific areas covered in the journal include: Physiology and pathophysiology of visual centers, Eye movement disorders and strabismus, Cellular, biochemical, and molecular features of the visual system, Structural and functional organization of the eye and of the visual cortex, Metabolic demands of the visual system, Diseases and disorders with neuro-ophthalmic manifestations, Clinical and experimental neuro-ophthalmology and visual system pathologies, Epidemiological studies.
期刊最新文献
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