Department of Ophthalmology III, Quinze-Vingts Hospital, Paris, France.
Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
Invest Ophthalmol Vis Sci. 2018 Feb 1;59(2):870-877. doi: 10.1167/iovs.17-22996.
To analyze retinal and choroidal microvasculature in patients with nonarteritic anterior ischemic optic neuropathy (NAION) by using optical coherence tomography angiography (OCT-A).
In this case-control retrospective observational study, patients with atrophic NAION (at least 3 months after onset of symptoms) and normal subjects underwent a complete ophthalmic examination including spectral-domain OCT, visual field (VF), and OCT-A. Whole en face image vessel density (wiVD) was used to assess retinal blood flow of the radial peripapillary capillaries (RPCs), circumpapillary RPC vessel density (cpVD), superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). Statistical correlations between wiVD measurements and visual acuity, VF parameters, retinal nerve fiber layer (RNFL), and combined thickness of retinal ganglion cell and inner plexiform layers were analyzed.
Twenty-four patients (26 eyes) with NAION and 24 age-matched normal controls (NCs) (24 eyes) were included. OCT-A showed significant reduction of the RPC wiVD (P < 0.0001) and the cpVD (P < 0.0001) in NAION eyes compared with NC and correlated with RNFL thickness (P = 0.002, P = 0.004), visual acuity (P = 0.042), and mean deviation of the VF (P = 0.001). Macular OCT angiograms showed capillary rarefaction in the SCP (P < 0.0001) and DCP (P < 0.0001) in the NAION group, both correlated with visual acuity (P = 0.02, P = 0.024). However, wiVD of the CC was not significantly different between the two groups in the peripapillary (P = 0.218) and macular (P = 0.786) areas.
OCT-A provided detailed visualization of the peripapillary and macular retinal capillary rarefaction, correlated with VF and visual acuity loss. OCT-A could be a useful tool for quantifying and monitoring ischemia in NAION.
利用光相干断层扫描血管造影术（OCT-A）分析非动脉炎性前部缺血性视神经病变（NAION）患者的视网膜和脉络膜微血管。
在这项病例对照回顾性观察研究中，对至少在症状出现后 3 个月出现萎缩性 NAION 的患者（n=24）和正常对照者（n=24）进行了全面的眼科检查，包括频域 OCT、视野（VF）和 OCT-A。全视盘面血管密度（wiVD）用于评估放射状视盘毛细血管（RPC）的视网膜血流、环视盘 RPC 血管密度（cpVD）、浅层毛细血管丛（SCP）、深层毛细血管丛（DCP）和脉络膜毛细血管（CC）。分析 wiVD 测量值与视力、VF 参数、视网膜神经纤维层（RNFL）和视网膜节细胞和内丛状层联合厚度之间的相关性。
共纳入 24 例（26 只眼）NAION 患者和 24 例年龄匹配的正常对照者（24 只眼）。OCT-A 显示，NAION 眼的 RPC wiVD（P＜0.0001）和 cpVD（P＜0.0001）明显降低，与 RNFL 厚度相关（P=0.002，P=0.004），与视力（P=0.042）和 VF 的平均偏差相关（P=0.001）。黄斑 OCT 血管造影显示，SCP（P＜0.0001）和 DCP（P＜0.0001）中毛细血管稀疏，这与视力均相关（P=0.02，P=0.024）。然而，在视盘周围（P=0.218）和黄斑（P=0.786）区域，两组间 CC 的 wiVD 无显著差异。
OCT-A 提供了视盘周围和黄斑视网膜毛细血管稀疏的详细可视化，与 VF 和视力丧失相关。OCT-A 可能是量化和监测 NAION 缺血的有用工具。
