Balducci Nicole, Morara Mariachiara, Veronese Chiara, Barboni Piero, Casadei Nicoletta Lelli, Savini Giacomo, Parisi Vincenzo, Sadun Alfredo A, Ciardella Antonio
Studio Oculistico d'Azeglio, Piazza Galileo 6, 40123, Bologna, Italy.
Ophthalmology Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Graefes Arch Clin Exp Ophthalmol. 2017 Nov;255(11):2255-2261. doi: 10.1007/s00417-017-3774-y. Epub 2017 Aug 31.
The purpose of our study was to describe the feature of acute non-arteritic or arteritic anterior ischemic optic neuropathy (NA-AION and A-AION) using optical coherence tomography angiography (OCT-A) and to compare it with fluorescein angiography (FA) and indocyanine green angiography (ICGA).
In this retrospective, observational case-control study four NA-AION patients and one A-AION patient were examined by FA, ICGA and OCT-A within 2 weeks from disease presentation. The characteristics of the images were analyzed. Optic nerve head (ONH) and radial peripapillary capillaries (RPC) vessel densities (VDs) were compared between NA-AION and controls.
In two of four NA-AION cases and in the A-AION patient, OCT-A clearly identified the boundary of the ischemic area at the level of the optic nerve head, which was comparable to optic disc filling defects detected by FA. In the other two NA-AION cases, a generalized leakage from the disc was visible with FA, yet OCT-A still demonstrated sectorial peripapillary capillary network reduction. Both ONH and RPC VDs were reduced in NA-AION patients, when compared to controls.
OCT-A was able to identify microvascular defects and VD reduction in cases of acute optic disc edema due to NA-AION and A-AION. OCT-A provides additional information in ischemic conditions of the optic nerve head.
我们研究的目的是利用光学相干断层扫描血管造影（OCT-A）描述急性非动脉炎性或动脉炎性前部缺血性视神经病变（NA-AION和A-AION）的特征，并将其与荧光素血管造影（FA）和吲哚菁绿血管造影（ICGA）进行比较。
在这项回顾性观察性病例对照研究中，4例NA-AION患者和1例A-AION患者在发病后2周内接受了FA、ICGA和OCT-A检查。对图像特征进行分析。比较NA-AION患者与对照组之间视神经乳头（ONH）和视乳头周围放射状毛细血管（RPC）的血管密度（VD）。
在4例NA-AION病例中的2例以及A-AION患者中，OCT-A在视神经乳头水平清晰地识别出缺血区域的边界，这与FA检测到的视盘充盈缺损相当。在另外2例NA-AION病例中，FA可见视盘有广泛渗漏，但OCT-A仍显示视乳头周围扇形毛细血管网减少。与对照组相比，NA-AION患者的ONH和RPC的VD均降低。
OCT-A能够识别因NA-AION和A-AION导致的急性视盘水肿病例中的微血管缺陷和VD降低。OCT-A在视神经乳头缺血情况下可提供额外信息。
