BACKGROUND Macular ganglion cell-inner plexiform layer (mGCIPL) is an emerging biomarker of neuroaxonal degeneration in multiple sclerosis (MS). OBJECTIVE We aimed to determine cut-off values of mGCIPL thinning for discriminating between progressing and stable patients in relapsing multiple sclerosis (RMS). METHODS This is a 3-year prospective longitudinal study on 183 RMS patients with annual optical coherence tomography. Best possible cut-off values of baseline mGCIPL and annual loss of macular ganglion cell-inner plexiform layer (aLmGCIPL) for discriminating clinically progressing (physical progression or cognitive decline) from stable patients were defined by receiver operating characteristics analysis and tested using multivariate regression models. RESULTS Baseline mGCIPL thickness <77 µm was associated with an increased risk (hazard ratio: 2.7, 95% confidence interval (CI): 1.5-4.7, p < 0.001) of disability progression. An aLmGCIPL cut-off ⩾1 µm accurately identified clinically progressing patients (87% sensitivity at 90% specificity) and was a strong predictor of clinical progression (odds ratio: 18.3, 95% CI: 8.8-50.3). CONCLUSION We present evidence that cross-sectionally measured mGCIPL thickness and annualized thinning rates of mGCIPL are able to identify clinically progressing RMS with high accuracy.

中文翻译：

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黄斑神经节细胞——内丛状层变薄作为复发性多发性硬化症残疾进展的生物标志物

背景黄斑神经节细胞内丛状层（mGCIPL）是多发性硬化症（MS）中神经轴索变性的新兴生物标志物。目标我们旨在确定 mGCIPL 变薄的临界值，以区分复发性多发性硬化症 (RMS) 的进展和稳定患者。方法 这是一项为期 3 年的前瞻性纵向研究，对 183 名 RMS 患者进行年度光学相干断层扫描。基线 mGCIPL 的最佳可能临界值和黄斑神经节细胞内丛状层 (aLmGCIPL) 的年度损失用于区分稳定患者的临床进展（身体进展或认知能力下降）通过接受者操作特征分析定义并使用多变量进行测试回归模型。结果基线 mGCIPL 厚度 < 77 µm 与残疾进展的风险增加有关（风险比：2.7，95% 置信区间 (CI)：1.5-4.7，p <0.001）。aLmGCIPL 临界值⩾1 µm 准确识别临床进展患者（敏感性为 87%，特异性为 90%），并且是临床进展的强预测因子（比值比：18.3，95% CI：8.8-50.3）。结论 我们提出的证据表明，横断面测量的 mGCIPL 厚度和 mGCIPL 的年化变薄率能够以高精度识别临床进展的 RMS。