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

Authors

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

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

Literatur
1 Barkhof F, Calabresi PA, Miller DH, Reingold SC. Imaging outcomes for neuroprotection and repair in multiple sclerosis trials. Nat Rev Neurol 2009; 05 (05) 256-266.
2 Cettomai D, Pulicken M, Gordon-Lipkin E. et al. Reproducibility of optical coherence tomography in multiple sclerosis. Arch Neurol 2008; 65 (09) 1218-1222.
3 Costello F, Coupland S, Hodge W. et al. Quantifying axonal loss after optic neuritis with optical coherence tomography. Ann Neurol 2006; 59 (06) 963-969.
4 Fisher JB, Jacobs DA, Markowitz CE. et al. Relation of visual function to retinal nerve fiber layer thickness in multiple sclerosis. Ophthalmology 2006; 113 (02) 324-332.
5 Frohman EM, Costello F, Zivadinov R. et al. Optical coherence tomography in multiple sclerosis. Lancet Neurol 2006; 05: 853-863.
6 Frohman EM, Fujimoto JG, Frohman TC. et al. Optical coherence tomography: A window into the mechanisms of multiple sclerosis. Nat Clin Pract Neurol 2008; 04 (12) 664-675.
7 Fu Y, Talavage TM, Cheng JX. New imaging techniques in the diagnosis of multiple sclerosis. Expert Opin Med Diagn 2008; 02 (09) 1055-1065.
8 Gordon-Lipkin E, Chodkowski B, Reich DS. et al. Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology 2007; 69 (16) 1603-1609.
9 Grazioli E, Zivadinov R, Weinstock-Guttman B. Retinal nerve fiber layer thickness is associated with brain MRI outcomes in multiple sclerosis. J Neurol Sci 2008; 268 (1–2): 12-17.
10 Gurses-Ozden R, Teng C, Vessani R. et al. Macular and retinal nerve fiber layer thickness measurement reproducibility using optical coherence tomography (oct-3). J Glaucoma 2004; 13 (03) 238-244.
11 Henderson AP, Trip SA, Schlottmann PG. et al. An investigation of the retinal nerve fibre layer in progressive multiple sclerosis using optical coherence tomography. Brain 2008; 131 (01) 277-287.
12 Huang D, Swanson EA, Lin CP. et al. Optical coherence tomography. Science 1991; 254 (5035): 1178-1181.
13 McDonald WI, Compston A, Edan G. et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50 (01) 121-127.
14 Parisi V, Manni G, Spadaro M. et al. Correlation between morphological and functional retinal impairment in multiple sclerosis patients. Invest Ophthalmol Vis Sci 1999; 40 (11) 2520-2527.
15 Petzold A, de Boer JF, Schippling S. et al. Optical coherence tomography in multiple sclerosis: a systematic review and meta-analysis. Lancet Neurol 2010; 09: 921-932.
16 Pulicken M, Gordon-Lipkin E, Balcer LJ. Optical coherence tomography and disease subtype in multiple sclerosis. Neurology 2007; 69 (22) 2085-2092.
17 Saidha S, Syc SB, Ibrahim MA. et al. Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography. Brain 2011; 134 (02) 518-533.
18 Sakata LM, Deleon-Ortega J, Sakata V, Girkin CA. Optical coherence tomography of the retina and optic nerve – a review. Clin Experiment Ophthalmol 2009; 37 (01) 90-99.
19 Siger M, Dziegielewski K, Jasek L. et al. Optical coherence tomography in multiple sclerosis: thickness of the retinal nerve fiber layer as a potential measure of axonal loss and brain atrophy. J Neurol 2008; 255 (10) 1555-1560.
20 Sospedra M, Martin R. Immunology of multiple sclerosis. Annu Rev Immunol 2005; 23: 683-747.
21 Syc SB, Warner CV, Hiremath GS. et al. Reproducibility of high-resolution optical coherence tomography in multiple sclerosis. Mult Scler 2010; 16 (07) 829-839.
22 Talman LS, Bisker ER, Sackel DJ. et al. Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. Ann Neurol 2010; 67 (06) 749-760.
23 Trapp BD, Peterson J, Ransohoff RM. et al. Axonal transsection in the lesions of multiple sclerosis. N Engl J Med 1998; 338: 278-285.
24 Trip SA, Schlottmann PG, Jones SJ. et al. Optic nerve atrophy and retinal nerve fibre layer thinning following optic neuritis: Evidence that axonal loss is a substrate of mri-detected atrophy. Neuroimage 2006; 31 (01) 286-293.
25 Zaveri MS, Conger A, Salter A. et al. Retinal imaging by laser polarimetry and optical coherence tomography evidence of axonal degeneration in multiple sclerosis. Arch Neurol 2008; 65 (07) 924-928.