Procena rezultata morfološkog i funkcionalnog ispitivanja mrežnjače kod bolesnika sa optičkim neuritisom u sklopu multiple skleroze
Sažetak
Uvod/Cilj. Jednostrani optički neuritis (ON), kao i njegov patofiziološki supstrat, retrobulbarni neuritis (RBN), česta je manifestacija multiple skleroze (MS). Cilj rada bio je da se utvrdi dijagnostički i prognostički potencijal nove metode funkcijskog i strukturnog ispitivanja oka, tzv. „swept-source“ optičke koherentne tomografije (SS-OKT) i OKT angiografije (OKTA), kod bolesnika sa prethodnom epizodom RBN u okviru MS. Metode. Za ispitivanje strukture i funkcije mrežnjače bolesnika sa MS, kako u oku na kome je dijagnostikovan ON, tako i na kontralateralnom oku, korišćene su nove metode, OKT i OKTA. Dobijeni rezultati upoređivani su sa rezultatima istovetnog ispitivanja na levom i desnom oku zdravih ispitanika. Rezultati. Korišćenjem OKT, pokazane su značajne razlike u strukturnom integritetu i debljini pojedinih slojeva mrežnjače u oku bolesnika sa RBN, u poređenju sa kontralateralnim okom (83,73 ± 18,36 vs. 98,67 ± 11,84; p = 0,013). Sa druge strane, nisu pokazane značajne razlike u perfuziji horoidnog pleksusa ni u jednom oku tih bolesnika (41,86 ± 1,52 vs. 42,52 ± 1,40; p = 0,228). Interesantno, poređenjem oka obolelih koje nije bilo zahvaćeno RBN sa zdravim kotrolama, pronađena je značajna razlika u debljini slojeva mrežnjače između kontralateralnog oka bolesnika i oba zdrava oka zdravih ispitanika. Pregled pomoću OKT pokazao je posebno značajno istanjenje unutrašnjeg pleksiformnog makularnog sloja mrežnjače (61,07 ± 5,04 vs. 67,53 ± 4,57; p < 0,001). Zaključak. Naše istraživanje pokazalo je da OKT i OKTA, kao dragocene metode u dijagnostici i prognozi, pružaju odlične mogućnosti za bezbednu, pouzdanu i ponavljanu procenu strukturnih i funkcijskih promena na mrežnjači, ali i za dalja istraživanja mehanizama koja dovode do takvih promena. Takođe, unutrašnji pleksiformni makularni sloj mrežnjače bi mogao biti naročito osetljiv i vredan biomarker u praćenju patoloških promena kod bolesnika sa MS, a moguće i kod drugih neurodegenerativnih oboljenja.
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