Optische Kohärenztomografie in der Multiplen Sklerose

M. Wölbert; A. U. Brandt; F. Paul; S. Schippling

doi:10.1055/s-0038-1628385

Nervenheilkunde, Table of Contents

Nervenheilkunde 2011; 30(07): 493-497
DOI: 10.1055/s-0038-1628385

Multiple Sklerose

Schattauer GmbH

Optische Kohärenztomografie in der Multiplen Sklerose

Optical coherence tomography in multiple sclerosis

M. Wölbert

¹Institut für Neuroimmunologie und Klinische Multiple Sklerose Forschung (inims), Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg Eppendorf, Hamburg

,

A. U. Brandt

²NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin

,

F. Paul

²NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin

,

S. Schippling

¹Institut für Neuroimmunologie und Klinische Multiple Sklerose Forschung (inims), Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg Eppendorf, Hamburg

› Author Affiliations

Abstract

Zusammenfassung

Die Multiple Sklerose (MS) ist eine entzündliche und degenerative Autoimmunerkrankung des Zentralnervensystems. Die Magnetresonanztomografie erlaubt über eine quantitative Bestimmung der Hirnparenchymfraktion (brain parenchymal fraction, BPF) sowie der T1-Hypointensitäten (T1 hypointensities/ black holes) die Darstellung des Ausmaßes axonaler bzw. neuronaler Schädigung. Mittels optischer Kohärenztomografie (optical coherence tomography, OCT) konnten mehrere Querschnittsstudien eine stadienabhängige Abnahme der mittleren Schichtdicke der Retinanervenfasern bei MS-Patienten nachweisen. Erste longitudinale Daten zeigen, dass auch ohne Optikusneuritis in der Vorgeschichte die Retinanervenfaserschicht bei MS über das altersnormale Maß hinaus im Verlauf der Erkrankung abnimmt. Die Parameter der retinalen Atrophie in der OCT korrelieren darüber hinaus mit dem Ausmaß der Hirn atrophie gemessen an der BPF im MRT. Weitere longitudinale Studien mit neuester OCT-Technologie sowie interventionelle Studien müssen zukünftig zeigen, inwieweit das OCT als Parameter für das Ausmaß der Neurodegeneration in klinische MS-Studien integriert werden kann.

Summary

Multiple sclerosis (MS) is an inflammatory and degenerative autoimmune disease of the central nervous system. Magnetic resonance imaging allows the quantification of axonal and neuronal damage by assessing the brain parenchymal fraction (BPF) and the extent of T1 hypointensities (black holes). Studies using optical coherence tomography (OCT) in MS consistently show increasing retinal nerve fiber layer thinning depending on the disease stage. Preliminary longitudinal data suggest that, irrespective of a history of optic neuritis, retinal nerve fiber layer thinning is increased during the course of MS beyond the level of what can be expected by normal aging. In addition, measures of retinal atrophy correlate with the extent of cerebral atrophy as assessed by BPF in MRI. Further longitudinal and future interventional trials with latest OCT technology are mandatory to prove if OCT outcomes can be integrated as a surrogate for neurodegeneration in clinical MS trials.

Schlüsselwörter

Multiple Sklerose - optische Kohärenztomografie - Retinanervenfaserschichtdicke

Keywords

Multiple sclerosis - optical coherence tomography - retinal nerve fiber layer

Full Text

References

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