TY - JOUR T1 -无症状视神经病变JF - Neurology JO - Neurology S半岛投注体育官网P - e2468 LP - e2478 DO - 10.1212/WNL.0000000000009504六世- 94 - 23 AU -让-巴蒂斯特·提高盟Renaud Lopes盟Elodie Drumez AU -朱利安Labreuche盟纳瓦尔Hadhoum AU -朱利安Lannoy AU -帕特里克Vermersch AU - jean - pierre Pruvo AU - Xavier勒克莱尔盟海琳Zephir AU - Olivier Outteryck Y1 - 2020/06/09 UR - //www.ebmtp.com/content/94/23/e2468.abstract N2 -目的探讨无症状的频率在无症状半岛投注体育官网视网膜视神经病变及其作用neuroaxonal损失在多发性硬化症(MS)。方法:我们纳入了VWIMS研究(多发性硬化症视觉神经退行性过程分析)(ClinicalTrials.gov识别码:03656055)的缓解复发性MS患者。纳入的患者接受了光学相干断层扫描(OCT)、视神经和脑MRI，以及低对比度视力测量。在无视神经炎(MS- non)的MS患者眼中，视神经病变在MRI (3D双反转恢复[DIR]序列)上被认为是无症状病变。我们考虑了以下OCT/MRI测量:乳头周围视网膜神经纤维层厚度、黄斑神经节细胞+内丛状层(mGCIPL)体积、视神经病变长度、T2病变负荷和视光辐射的分数各向异性。结果半数MS-NON眼可见视神经病变。与无任何病变且独立于视神经辐射病变的视神经相比，无症状病变与视网膜内层较薄相关(p <0.0001)和较低的对比视力(p≤0.003)。在无症状视神经病变的眼睛中，视神经病变长度是唯一与视网膜神经轴突丧失显著相关的MRI测量(p <0.03)。双侧视神经DIR高信号患者的眼间mGCIPL厚度差(IETD)低于单侧高信号患者(p = 0.0317)。 For the diagnosis of history of optic neuritis, sensitivity of 3D DIR and of mGCIPL IETD were 84.9% and 63.5%, respectively.Conclusions Asymptomatic optic nerve lesions are an underestimated and preponderant cause of retinal neuroaxonal loss in MS. 3D DIR sequence may be more sensitive than IETD measured by OCT for the detection of optic nerve lesions.CIS=clinically isolated syndrome; CIS-NON=clinically isolated syndrome without history of optic neuritis; DIR=double inversion recovery; DTI=diffusion tensor imaging; EPI=echoplanar imaging; FA=fractional anisotropy; FLAIR=fluid-attenuated inversion recovery; FOV=field of view; IETD=intereye retinal thickness differences; INL=inner nuclear layer; IQR=interquartile range; mGCIPL=macular ganglion cell + inner plexiform layer; mINL=macular inner nuclear layer; MME=microcystic macular edema; MS=multiple sclerosis; MS-NON=multiple sclerosis without history of optic neuritis; MS-ON=multiple sclerosis with history of optic neuritis; OCT=optical coherence tomography; ON=optic neuritis; ORs=optic radiations; pRNFL=peripapillary retinal nerve fiber layer; RNFL=retinal nerve fiber layer; RRMS=relapsing-remitting multiple sclerosis; TE=echo time; TI=inversion time; TR=repetition time; VA=visual acuity; VEP=visual evoked potential ER -