OCT及OCTA评估水通道蛋白-4抗体阳性NMOSD视网膜结构和血管密度及其与临床特征的关系  

Optical coherence tomography and angiography evaluates retina and vascular density in aquaporin-4 antibody positive neuromyelitis optica spectrum disorders

作　　者：要雅君 李昕頔 徐芸 梁小芳 杨柳[2] 田德财 张星虎[1] YAO Yajun;LI Xindi;XU Yun;LIANG Xiaofang;YANG Liu;TIAN Decai;ZHANG Xinghu(不详;Center for Neuroinflammation,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经感染与免疫科,100070 [2]首都医科大学附属北京天坛医院眼科,100070

出　　处：《中国神经免疫学和神经病学杂志》2024年第4期251-257,264,共8页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的应用光学相干断层扫描(optical coherence tomography,OCT)及血管成像(optical coherence tomography angiography,OCTA)评价视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSD)视网膜结构和血管密度改变及其与临床疾病特征的相关性。方法共纳入水通道蛋白-4抗体阳性的NMOSD患者42例(84只眼),健康对照(对照组)45名(90只眼)。根据视神经炎(optic neuritis,ON)病史,NMOSD组进一步分为两组:有ON病史的NMOSD+ON组和无ON病史的NMOSD-ON组。通过OCT和OCTA测量神经节细胞复合体(ganglion cell complex,GCC)厚度、视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度、黄斑区浅层毛细血管丛(superficial capillary plexus,SCP)、深层毛细血管丛(deep capillary plexus,DCP)和视盘区血管的血管密度。记录患者NMOSD病程和发作次数、最佳矫正视力(best corrected visual acuity,BCVA)和扩展残疾状态量表(expanded disability status scale,EDSS)评分,分析上述指标与OCT和OCTA观察指标之间的相关性。结果黄斑和视盘的结构改变:与对照组比较,NMOSD+ON组总体及颞区(TEM)、上区(SUP)、鼻区(NAS)、下区(INF)各区的RNFL厚度均明显降低(P<0.05);NMOSD-ON组总体和SUP区的RNFL厚度明显降低(P<0.05)。与NMOSD-ON组比较,NMOSD+ON组总体及TEM、SUP、NAS、INF各区的RNFL厚度均明显降低(P<0.05)。与对照组比较,NMOSD+ON组总体、SUP及INF区的GCC厚度明显降低(P<0.05);NMOSD-ON组总体及SUP区的GCC厚度明显降低(P<0.05)。与NMOSD-ON组比较,NMOSD+ON组总体GCC厚度及SUP、INF区的GCC厚度明显降低(P<0.05)。黄斑区血管密度:与对照组比较,NMOSD+ON组SCP总体、中心凹、中心凹旁及中心凹周围TEM、SUP、NAS、INF各区血管密度均明显降低(P<0.05)。与对照组比较,NMOSD-ON组DCP总体血管密度、中心凹旁及中心凹周围TEM、SUP、NAS、INF各区血管密度均明显降低(P<0.05)。与NMOSD-ON组比较,NMOSD+ON组SCP总体血管密度以及中心凹旁TEM区�Objective Using optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)to evaluate changes in retinal structure and vascular density in neuromyelitis optica spectrum disorders(NMOSD),and exploring their correlation with clinical disease features.Methods This study enrolled 42 NMOSD patients with aquaporin-4 antibody positive(84 eyes)and 45 healthy controls(90 eyes).Based on the history of optic neuritis(ON),the NMOSD group was further divided into two groups:NMOSD patients with a history of ON(NMOSD+ON group)and those without a history of ON(NMOSD-ON group).OCT and OCTA were used to obtain measurements of the ganglion cell complex(GCC),the retinal nerve fiber layer(RNFL),the superficial capillary plexus(SCP),the deep capillary plexus(DCP),and the vascular density of the optic disc area.NMOSD duration and number of episodes,best corrected visual acuity(BCVA),and Expanded Disability Status Scale(EDSS)scores were recorded to analyze the correlation between these indicators and OCT and OCTA parameters.Results Structural changes in the macula and optic disc:Compared with the control group,the overall RNFL thickness and temporal(TEM),superior(SUP),nasal(NAS)and inferior(INF)RNFL thickness in the NMOSD+ON group were significantly decreased(P<0.05).The overall RNFL thickness and SUP RNFL thickness in the NMOSD-ON group were significantly decreased(P<0.05).Compared with the NMOSD-ON group,the overall RNFL thickness and TEM,SUP,NAS and INF RNFL thickness in the NMOSD+ON group were significantly decreased(P<0.05).Compared with the control group,the GCC thickness of overall,SUP and INF in the NMOSD+ON group was significantly decreased(P<0.05).The overall and SUP GCC thickness of NMOSD-ON group was significantly lower than that of the control group(P<0.05).Compared with NMOSD-ON group,the GCC thickness of overall,SUP and INF in NMOSD+ON group was significantly decreased(P<0.05).Comparison of macular vessel density:compared with the control group,the vessel density of SCP overall,foveal,parafoveal T

关 键 词：视神经脊髓炎谱系疾病 水通道蛋白-4 光学相干断层扫描血管成像 

分 类 号：R744.52[医药卫生—神经病学与精神病学]