Diagnostic accuracy of inter-eye difference of ganglion cell layer alone in identifying optic neuritis in multiple sclerosis.

IF 5 2区医学 Q1 CLINICAL NEUROLOGY

Multiple Sclerosis Journal Pub Date : 2025-08-01 Epub Date: 2025-04-22 DOI:10.1177/13524585251332895

Nik Krajnc, Fabian Föttinger, Markus Ponleitner, Barbara Kornek, Fritz Leutmezer, Stefan Macher, Paulus Rommer, Christiane Schmied, Karin Zebenholzer, Gudrun Zulehner, Tobias Zrzavy, Thomas Berger, Berthold Pemp, Gabriel Bsteh

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引用次数: 0

Abstract

Introduction: The 2024 McDonald criteria for diagnosing multiple sclerosis (MS) include optic nerve involvement as a fifth region for establishing dissemination in space. Optic neuritis (ON) can be detected through optical coherence tomography (OCT) using an inter-eye absolute or percentage difference (IEAD, IEPD) in ganglion cell-inner plexiform layer (GCIPL) thickness.

Objective: To compare the diagnostic accuracy of GCIPL IEAD/IEPD with GCL and IPL IEAD/IEPD alone for identifying a history of ON.

Methods: This cross-sectional retrospective study included people with MS (pwMS) who underwent an OCT scan. Diagnostic accuracy was assessed using ROC analysis.

Results: A total of 241 pwMS (mean age 34.7 years [SD 9.7], 70.1% female) were included. Sixty-eight (28.2%) patients had a documented history of unilateral ON. GCL IEAD (AUC 0.79, cut-off ⩾ 0.06 mm³ or ⩾2µm, 58.9% sensitivity, 85.1% specificity) and IEPD (AUC 0.80, cut-off ⩾ 3%, 48.7% sensitivity, 89.8% specificity) demonstrated excellent diagnostic accuracy for unilateral ON, showing non-inferiority to the established GCIPL IEAD/IEPD.

Conclusion: GCL IEAD and IEPD provide strong diagnostic accuracy for identifying unilateral ON and can be effectively used as an alternative to GCIPL IEAD/IEPD to facilitate implementation in clinical routine.

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单用神经节细胞层眼间差异诊断多发性硬化症视神经炎的准确性。

2024年诊断多发性硬化症（MS）的McDonald标准将视神经受累作为建立空间传播的第五个区域。视神经炎（ON）可以通过光学相干断层扫描（OCT）检测，使用神经节细胞-内丛状层（GCIPL）厚度的眼间绝对差或百分比差（IEAD， IEPD）。目的：比较GCIPL IEAD/IEPD与GCL和IPL IEAD/IEPD单独诊断ON病史的准确性。方法：这项横断面回顾性研究包括接受OCT扫描的多发性硬化症（pwMS）患者。采用ROC分析评估诊断准确性。结果：共纳入241例pwMS患者（平均年龄34.7岁[SD 9.7]， 70.1%为女性）。68例（28.2%）患者有单侧ON病史。GCL IEAD （AUC 0.79，截止时间小于0.06 mm3或小于或等于2µm， 58.9%敏感性，85.1%特异性）和IEPD （AUC 0.80，截止时间小于或等于3%，48.7%敏感性，89.8%特异性）显示出单侧ON的出色诊断准确性，显示出对已建立的GCIPL IEAD/IEPD的非劣势性。结论：GCL - IEAD和IEPD对单侧ON有较强的诊断准确性，可有效替代GCIPL - IEAD/IEPD，便于临床常规实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple Sclerosis Journal 医学-临床神经学

CiteScore

10.90

自引率

6.90%

发文量

186

审稿时长

3-8 weeks

期刊介绍： Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system. The journal for your research in the following areas: * __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics * __Epidemology and genetics:__ genetics epigenetics, epidemiology * __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures * __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management Print ISSN: 1352-4585