PT - JOURNAL ARTICLE AU - Jean-Baptiste Davion AU - Renaud Lopes AU - Élodie Drumez AU - Julien Labreuche AU - Nawal Hadhoum AU - Julien Lannoy AU - Patrick Vermersch AU - Jean-Pierre Pruvo AU - Xavier Leclerc AU - h2013.2013.09 /WNL.0000000000009504DP - 2020 Jun 09 TA - 半岛投注体育官网Neurology PG - e2468—e2478 VI - 94 IP - 23 4099 - //www.ebmtp.com/content/94/23/e2468.short 4100 - //www.ebmtp.com/content/94/23/e2468.full SO - Neurology2020 Jun 09;目的探讨多发性硬化症(MS)无症状视神经病变的发生频率及其在无症状视网膜神经轴突丧失中的作用。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). Intereye mGCIPL thickness difference (IETD) was lower in patients with bilateral optic nerve DIR hypersignal compared to patients with unilateral hypersignal (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

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