MONITORING OF OPHTHALMOLOGICAL INDICATORS IN PATIENTS WITH MULTIPLE SCLEROSIS
- Authors: Andryukhina O.M.1, Ryabtseva A.A.1, Kotov S.V.1, Yakushina T.I.1, Kuchina N.V.1
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Issue: No 36 (2015)
- Pages: 53-58
- Section: INFLAMMATORY AND DEGENERATIVE EYE DISEASES
- URL: https://almclinmed.ru/jour/article/view/221
- DOI: https://doi.org/10.18786/2072-0505-2015-36-53-58
- ID: 221
Cite item
Full Text
Abstract
Background: According to the literature data, more than 70% of patients diagnosed with multiple sclerosis with disease duration > 5 years and absence of retrobulbar neuritis, have visual analyzer involvement manifested by decreased thickness of peripapillary nervous fibers.
Aim: To assess interrelations between retinal/optic nerve changes and clinical signs of multiple sclerosis; to estimate prognostic value of optic coherence tomography in the monitoring of patients with multiple sclerosis.
Materials and methods: We studied 132 eyes of 66 patients (41 women, 62.12%, and 25 men, 37.8%, age 20–57 years old) with verified diagnosis of relapsing-remitting multiple sclerosis. All patients underwent routine ophthalmological examination and optical coherence tomography every 3 months during 2 years.
Results: Significant correlations were demonstrated between disability severity (Expanded Disability Status Scale, EDSS) and changes of total thickness of peripapillary nervous fibers (r = -0.362, p = 0.042), mean thickness of superior temporal peripapillary nerve fibers (r = -0.373, p = 0.046), mean thickness of inferotemporal peripapillary nerve fibers (r = -0.504, p = 0.005), optic disc volume (r = -0.645, p = 0.001), total retinal thickness at the posterior pole of the eyeball (r = -0.470, p = 0.010), and total retinal volume (r = -0.453, p = 0.012). Demonstrated relations were independent of the history of retrobulbar neuritis.
Conclusion: Changes of visual analyzer demonstrated in optical coherence tomography reflect the severity of diffuse neurodegenerative process in the brain and correlate well with disability and disease progression.
About the authors
O. M. Andryukhina
Moscow Regional Research and Clinical Institute (MONIKI)
Author for correspondence.
Email: a-olya86@mail.ru
Junior Research Associate, Ophthalmology Department
РоссияA. A. Ryabtseva
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Professor, Chief of the Ophthalmology Department
РоссияS. V. Kotov
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Professor, Chief of the Neurology Department, Postgraduate Medical School
РоссияT. I. Yakushina
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
PhD, Senior Research Associate, Neurology Department
РоссияN. V. Kuchina
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Fellow, Neurology Department, Postgraduate Medical School
РоссияReferences
- Котов СВ, Якушина ТИ, Лиждвой ВЮ. Ребаунд-феномен и восстановление активности рассеянного склероза при прекращении терапии финголимодом. Русский медицинский журнал. 2014;(22):1596–1600. (Kotov SV, Yakushina TI, Lizhdvoy VYu. [Rebound-phenomenon and relapse of activity of multiple sclerosis after withdrawal of fingolimod]. Russkiy meditsinskiy zhurnal. 2014;(22):1596–1600. Russian).
- Haines JD, Inglese M, Casaccia P. Axonal damage in multiple sclerosis. Mt Sinai J Med. 2011;78(2):231–43.
- Шмидт ТЕ. Воспаление и нейродегенерация при рассеянном склерозе. Неврологический журнал. 2006;(3):46–52. (Shmidt TE. [Inflammation and neurodegeneration in multiple sclerosis]. Nevrologicheskiy zhurnal. 2006;(3):46–52. Russian).
- Dutta R, Trapp BD. Mechanisms of neuronal dysfunction and degeneration in multiple sclerosis. Prog Neurobiol. 2011;93(1):1–12.
- Lassmann H. Multiple sclerosis: is there neurodegeneration independent from inflammation? J Neurol Sci. 2007;259(1–2):3–6.
- Кучина НВ, Андрюхина ОМ, Лапитан ДГ, Якушина ТИ, Котов СВ, Рябцева АА. Цветовое и контрастное зрение у пациентов с рассеянным склерозом в Московской области. Клиническая геронтология. 2014;(9–10): 18–21. (Kuchina NV, Andryukhina OM, Lapitan DG, Yakushina TI, Kotov SV, Ryabtseva AA. [Color and contrast visual acuity in patients with multiple sclerosis in Moscow Region]. Klinicheskaya gerontologiya. 2014;(9–10):18–21. Russian).
- Stys PK. Multiple sclerosis: autoimmune disease or autoimmune reaction? Can J Neurol Sci. 2010;37 Suppl 2:S16–23.
- Stadelmann C. Multiple sclerosis as a neurodegenerative disease: pathology, mechanisms and therapeutic implications. Curr Opin Neurol. 2011;24(3):224–9.
- Котов СВ, Якушина ТИ, Лиждвой ВЮ. Длительное сравнительное исследование эффективности препаратов, изменяющих течение рассеянного склероза. Альманах клинической медицины. 2011;25:37–40. (Kotov SV, Yakushina TI, Lizhdvoy VYu. [Longterm comparative study of disease-modifying therapies in multiple sclerosis]. Al’manakh klinicheskoy meditsiny. 2011;25:37–40. Russian).
- Котов СВ, Якушина ТИ, Лиждвой ВЮ. Клинико-эпидемиологические аспекты рассеянного склероза в Московской области. Журнал неврологии и психиатрии им. С.С. Корсакова. 2012;112(3):60–2. (Kotov SV, Iakushina TI, Lizhdvoĭ VIu. [Clinical and epidemiological aspects of multiple sclerosis in the Moscow Region]. Zh Nevrol Psikhiatr Im SS Korsakova. 2012;112(3 Pt 1):60–2. Russian).
- Коваленко АВ, Бисага ГН. Оптимизация алгоритма обследования зрительного анализатора при рассеянном склерозе. Неврологический вестник. 2010;42(1):153–5. (Kovalenko AV, Bisaga GN. [Improvement of algorithm for examination of visual analyzer in multiple sclerosis]. Nevrologicheskiy vestnik. 2010;42(1):153–5. Russian).
- Шмидт ТЕ, Яхно НН. Рассеянный склероз. М.: МЕДпресс-информ; 2010. 272 с. (Shmidt TE, Yakhno NN. Multiple sclerosis. Moscow: MEDpress-inform; 2010. 272 p. Russian).
- Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O’Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292–302.
- Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444–52.
- Rougier MB, Tilikete C. Ocular motor disorders in multiple sclerosis. J Fr Ophtalmol. 2008;31(7):717–21.
- Охоцимская СА, Жученко ТД, Шмидт ТЕ, Мешкова КС. Ретробульбарный неврит. В: Завалишин ИА, Головкин ВИ, ред.
- Рассеянный склероз. Избранные вопросы теории и практики. М.: Детская книга; 2000. c. 494–510. (Okhotsimskaya SA, Zhuchenko TD, Shmidt TE, Meshkova KS. Retrobulbar neuritis. In: Zavalishin IA, Golovkin VI, editors. Multiple sclerosis. Selected issues of theory and practice. Moscow: Detskaya kniga; 2000. p. 494–510. Russian).
- Shams PN, Plant GT. Optic neuritis: a review. Int MS J. 2009;16(3):82–9.
- Насруллаева НА, Гнездицкий ВВ, Гусейнова СК. Нарушение зрительных функций при различном клиническом течении рассеянного склероза. Нейроиммунология. 2009;7(1):74–5. (Nasrullaeva NA, Gnezditskiy VV, Guseynova SK. [Visual impairment in different clinical variants of multiple sclerosis]. Neyroimmunologiya. 2009;7(1):74–5. Russian).
- Марков ДА, Леонович АЛ. Рассеянный склероз: руководство для врачей. М.: Медицина; 1976. 274 с. (Markov DA, Leonovich AL. Multiple sclerosis: Physician guidance. Moscow: Meditsina; 1976. 274 p. Russian).