Optical Coherence Tomography of Retinal Nerve Fibre Layer in Multiple Sclerosis and its Correlation with The Disease Evolution

[摘要] Background: Because of the potential correlation between the neurological deficits in multiple sclerosis (MS) and axonal loss, in-vivo diagnosis and monitoring of axonal loss is important. Objective: To identify optical coherence tomography (OCT) measured retinal nerve fibre layer (RNFL) thickness changes in MS patients with and without optic neuritis (ON) and the correlation between such RNFL changes and the physical and cognitive disabilities. Methods: Thirty six definite MS patients and 30 healthy controls were enrolled. All subjects underwent full history and examination; cerebral magnetic resonance imaging (MRI); Expended disability status scale score (EDSS) with cutoff value 3.5; Neuropsychological scale tests were for assessment of cognitive functions. Peripapillary RNFL OCT scan images for each eye. Results: Course of MS was progressive in 33.3% and relapsing remitting in 66.7%. Mean of EDSS was 4.4±2.4 with EDSS >3.5 in 14 patients. Incidence of cognitive impairment was 39%. History of acute unilateral ON was present in 25% patients. Mean overall RNFL average thickness was significantly lower in MS patients with or without ON compared to controls (P<0.001). A significant negative correlation was reported between severity of physical disability with EDSS > 3.5 and cognitive impairment with >5 failed tests (P<0.01) and the mean overall RNFL average thickness (P<0.05). Conclusion: This study augments the role of OCT as a useful tool in the diagnosis and monitoring of axonal loss of RNFL in MS patients with and without ON. It also supports it as a sensitive biomarker for correlation between physical and cognitive deficits evolving during MS progress. (Egypt J Neurol Psychiat Neurosurg.  2010; 47(1): 21-27)

[学科分类] 精神健康和精神病学