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Title: [The role of aquaporin 4 antibody in the injury of retinal microstructure in neuromyelitis optica spectrum disorders].
Author: Wang ZW, Wang QQ, Diao DW, Guo QF, Qi XK.
Journal: Zhonghua Nei Ke Za Zhi; 2018 Jun 01; 57(6):435-439. PubMed ID: 29925129.
Abstract:
Objective: To evaluate the injury of retinal microstructure using optical coherence tomography (OCT) and investigate the role of aquaporin 4 antibody (AQP4 Ab) in this injury process. Methods: Forty patients with neuromyelitis optica spectrum disorders (NMOSD) were retrospectively studied, each of whom reported at least one episode of optic neuritis (ON), namely 59 ON eyes involved in all. All patients were divided into two subgroups based on AQP4 Ab tests including 25 patients (37 ON eyes) with AQP4 positive (Ab(+)/NMOSD group) and 15 patients (22 ON eyes) negative (Ab(-)/NMOSD group). In addition, 10 healthy controls (20 eyes) matched for age and sex (HC group) were analyzed. Spectral domain optical coherence tomography (SD-OCT) was used to quantify peripapillary retinal nerve fiber layer (RNFL). Nonparametric test was used to compare differences between groups. Results: Age distribution and gender ratio were comparable in three groups (P>0.05). Visual acuity in ON eyes of Ab(+)/NMOSD group was worse than that of Ab(-)/NMOSD group (P=0.02). There were no significant differences between Ab(+)/NMOSD and Ab(-)/NMOSD in aspects of disease duration (2.6 vs. 1.9 year), ON episodes (2 vs. 1), longitudinal extensive transverse myelitis (LETM) ratio (48.0% vs. 66.7%), NMOSD specific intracranial lesions ratio (32.0% vs. 53.3%), positive autoimmune antibody ratio (52.0% vs. 20.0%) (P= 0.13, 0.08, 0.25, 0.18, 0.06, respectively). The thickness of temporal, superior, nasal, inferior and average RNFL in ON eyes of both Ab(+)/NMOSD and Ab(-)/NMOSD group were thinner than those in eyes of HC group (all P<0.05). The thickness of superior and inferior RNFL in ON eyes of Ab(+)/NMOSD were 61.0 μm and 62.0 μm, which was thinner than those of Ab(-)/NMOSD 94.5 μm and 97.0 μm (P=0.03 and 0.01, respectively). Conclusions: RNFL reflects the injury of retinal microstructure in NMOSD patients. AQP4 Ab seropositivity is correlated to the severity of RNFL damage, implying the potential role of AQP4 Ab in this pathological process. 目的： 采用光学相干断层扫描(OCT)方法评价视神经脊髓炎谱系疾病(NMOSD)患者的视网膜微观结构损伤，并探讨水通道蛋白4抗体(AQP4 Ab)在这一损伤过程中的作用。 方法： 回顾性分析2012年1月至2017年1月海军总医院收治的伴有视神经炎(ON)的40例(59只ON眼)NMOSD患者临床资料，根据AQP4 Ab是否阳性分为两组：AQP4 Ab阳性NMOSD组（简称抗体阳性组），25例(37只ON眼)；AQP4 Ab阴性NMOSD组（简称抗体阴性组），15例(22只ON眼)。同时选取年龄和性别相匹配的健康对照者共10例(20只健康眼)为健康对照组。使用频域OCT完成视盘区视网膜神经纤维层厚度(RNFL)检查。比较3组各临床特征及RNFL的差异。 结果： 3组性别构成比和年龄的差异无统计学意义。抗体阳性组ON眼的视力损伤较抗体阴性组ON眼更严重(P=0.02)；抗体阳性组与抗体阴性组的病程(2.6年、1.9年)、ON发作次数(2次、1次)、长节段横贯性脊髓炎比例(48.0%、66.7%)、颅内NMOSD特异性病灶比例(32.0%、53.3%)、自身抗体阳性比例(52.0%、20.0%)的差异均无统计学意义(P值分别为0.13、0.08、0.25、0.18、0.06)。抗体阳性组和抗体阴性组ON眼的颞侧、上侧、鼻侧、下侧象限以及平均RNFL均小于健康对照组(P值均<0.05)。抗体阳性组ON眼的上侧、下侧RNFL分别为61.0 μm、62.0 μm，明显小于抗体阴性组(94.5 μm、97.0 μm) (P值分别为0.03、0.01)。 结论： RNFL可用来评估NMOSD患者视网膜微观结构损伤，AQP4 Ab阳性的NMOSD患者RNFL变薄更明显，提示AQP4 Ab在NMOSD视网膜病理损伤中起一定作用。.

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