Jiatong Li , Zexu Chen , Liu Yang , Tianshu Guan , Hai Yu , Wenbo Yang , Jia You , Weikang Gong , Jianfeng Feng , Xiangjun Chen
{"title":"视网膜层变薄作为中枢神经系统脱髓鞘疾病的预测因子:来自一项长达十年的队列研究的见解","authors":"Jiatong Li , Zexu Chen , Liu Yang , Tianshu Guan , Hai Yu , Wenbo Yang , Jia You , Weikang Gong , Jianfeng Feng , Xiangjun Chen","doi":"10.1016/j.jneuroim.2025.578614","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Early diagnosis and differentiation of demyelinating diseases of the central nervous system (CNS) are essential for timely treatment but challenged with the limited availability of non-invasive, real-time methods to assess the architecture of the CNS. This study compared the retinal layers between patients with CNS demyelinating diseases and the general population and evaluated the predictive value of these structures in prospective diagnosis.</div></div><div><h3>Methods</h3><div>This UK Biobank study, incorporating optical coherence tomography images, analyzed patients with CNS demyelinating diseases identified at recruitment and during follow-up. Cross-sectionally, baseline retinal structures were compared, with diagnostic models constructed following cross-validation. Cox regression was used to assess the risk of future diagnosis in the prospective cohort.</div></div><div><h3>Results</h3><div>34,230 individuals were included, comprising 61 diagnosed patients. The thickness of the macular ganglion cell-inner plexiform layer (mGCIPL; <em>p</em> = 4.91 × 10<sup>−10</sup>), papillary retinal nerve fiber layer (pRNFL; <em>p</em> = 9.92 × 10<sup>−6</sup>), and non-central macular subfields (<em>p</em> value ranging from 1.16 × 10<sup>−2</sup> to 1.18 × 10<sup>−10</sup>) were significantly thinner in the patient group. A diagnostic model incorporating mGCIPL, pRNFL and outer temporal macular thickness achieved the area under the curve of 0.779. During follow-up, 96 patients were newly diagnosed. Multivariable Cox regression revealed thinner mGCIPL (HR: 0.960, 95 % CI: 0.936 to 0.984, <em>p =</em> 0.001) and thinner outer nasal macula (HR: 0.990 95 % CI: 0.983 to 0.997, <em>p =</em> 0.006) as high risk predictors of future diagnosis.</div></div><div><h3>Conclusions</h3><div>Retinal structure can serve as non-invasive biomarker for CNS demyelinating diseases and has prospective diagnostic value in identifying pre-clinical and sub-clinical patients.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"404 ","pages":"Article 578614"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retinal layer thinning as a predictor of demyelinating diseases of the central nervous system: Insights from a decade-long cohort study\",\"authors\":\"Jiatong Li , Zexu Chen , Liu Yang , Tianshu Guan , Hai Yu , Wenbo Yang , Jia You , Weikang Gong , Jianfeng Feng , Xiangjun Chen\",\"doi\":\"10.1016/j.jneuroim.2025.578614\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Early diagnosis and differentiation of demyelinating diseases of the central nervous system (CNS) are essential for timely treatment but challenged with the limited availability of non-invasive, real-time methods to assess the architecture of the CNS. This study compared the retinal layers between patients with CNS demyelinating diseases and the general population and evaluated the predictive value of these structures in prospective diagnosis.</div></div><div><h3>Methods</h3><div>This UK Biobank study, incorporating optical coherence tomography images, analyzed patients with CNS demyelinating diseases identified at recruitment and during follow-up. Cross-sectionally, baseline retinal structures were compared, with diagnostic models constructed following cross-validation. Cox regression was used to assess the risk of future diagnosis in the prospective cohort.</div></div><div><h3>Results</h3><div>34,230 individuals were included, comprising 61 diagnosed patients. The thickness of the macular ganglion cell-inner plexiform layer (mGCIPL; <em>p</em> = 4.91 × 10<sup>−10</sup>), papillary retinal nerve fiber layer (pRNFL; <em>p</em> = 9.92 × 10<sup>−6</sup>), and non-central macular subfields (<em>p</em> value ranging from 1.16 × 10<sup>−2</sup> to 1.18 × 10<sup>−10</sup>) were significantly thinner in the patient group. A diagnostic model incorporating mGCIPL, pRNFL and outer temporal macular thickness achieved the area under the curve of 0.779. During follow-up, 96 patients were newly diagnosed. Multivariable Cox regression revealed thinner mGCIPL (HR: 0.960, 95 % CI: 0.936 to 0.984, <em>p =</em> 0.001) and thinner outer nasal macula (HR: 0.990 95 % CI: 0.983 to 0.997, <em>p =</em> 0.006) as high risk predictors of future diagnosis.</div></div><div><h3>Conclusions</h3><div>Retinal structure can serve as non-invasive biomarker for CNS demyelinating diseases and has prospective diagnostic value in identifying pre-clinical and sub-clinical patients.</div></div>\",\"PeriodicalId\":16671,\"journal\":{\"name\":\"Journal of neuroimmunology\",\"volume\":\"404 \",\"pages\":\"Article 578614\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neuroimmunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0165572825000955\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neuroimmunology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165572825000955","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Retinal layer thinning as a predictor of demyelinating diseases of the central nervous system: Insights from a decade-long cohort study
Background
Early diagnosis and differentiation of demyelinating diseases of the central nervous system (CNS) are essential for timely treatment but challenged with the limited availability of non-invasive, real-time methods to assess the architecture of the CNS. This study compared the retinal layers between patients with CNS demyelinating diseases and the general population and evaluated the predictive value of these structures in prospective diagnosis.
Methods
This UK Biobank study, incorporating optical coherence tomography images, analyzed patients with CNS demyelinating diseases identified at recruitment and during follow-up. Cross-sectionally, baseline retinal structures were compared, with diagnostic models constructed following cross-validation. Cox regression was used to assess the risk of future diagnosis in the prospective cohort.
Results
34,230 individuals were included, comprising 61 diagnosed patients. The thickness of the macular ganglion cell-inner plexiform layer (mGCIPL; p = 4.91 × 10−10), papillary retinal nerve fiber layer (pRNFL; p = 9.92 × 10−6), and non-central macular subfields (p value ranging from 1.16 × 10−2 to 1.18 × 10−10) were significantly thinner in the patient group. A diagnostic model incorporating mGCIPL, pRNFL and outer temporal macular thickness achieved the area under the curve of 0.779. During follow-up, 96 patients were newly diagnosed. Multivariable Cox regression revealed thinner mGCIPL (HR: 0.960, 95 % CI: 0.936 to 0.984, p = 0.001) and thinner outer nasal macula (HR: 0.990 95 % CI: 0.983 to 0.997, p = 0.006) as high risk predictors of future diagnosis.
Conclusions
Retinal structure can serve as non-invasive biomarker for CNS demyelinating diseases and has prospective diagnostic value in identifying pre-clinical and sub-clinical patients.
期刊介绍:
The Journal of Neuroimmunology affords a forum for the publication of works applying immunologic methodology to the furtherance of the neurological sciences. Studies on all branches of the neurosciences, particularly fundamental and applied neurobiology, neurology, neuropathology, neurochemistry, neurovirology, neuroendocrinology, neuromuscular research, neuropharmacology and psychology, which involve either immunologic methodology (e.g. immunocytochemistry) or fundamental immunology (e.g. antibody and lymphocyte assays), are considered for publication.