Ophthalmology Department, Ankara University Faculty of Medicine, Ankara, Turkey.
J Neuroophthalmol. 2019 Sep;39(3):319-323. doi: 10.1097/WNO.0000000000000745.
Although alterations in the peripapillary retinal nerve fiber layer (RNFL) in patients with idiopathic intracranial hypertension (IIH) have been characterized using optical coherence tomography (OCT), there are little data regarding the peripapillary vasculature in this patient population. Our aim was to evaluate findings of OCT angiography (OCT-A) in the peripapillary region in addition to the RNFL measurements on OCT in patients with IIH.
Thirty-eight eyes of 19 patients with IIH and 42 eyes of 21 healthy controls were enrolled in our study. Papilledema was graded according to the Frisen scale. Peripapillary RNFL and vessel density were evaluated with OCT and OCT-A, respectively.
RNFL thickness was found to be increased with OCT, but this was statistically significant only in the inferior location in IIH patients when compared with the control group. There was a significant decrease in mean peripapillary vessel density measured with OCT-A in IIH patients with papilledema when compared with the control group (P < 0.05).
In patients with IIH, there was a decrease in peripapillary vessel density measured by OCT-A, and this decrease may be a consequence of the swelling of axons in the peripapillary retina due to papilledema. However, autoregulatory vascular mechanisms may also play a role in decreased peripapillary vessel density.
尽管特发性颅内高压（IIH）患者的视盘周围视网膜神经纤维层（RNFL）改变已通过光学相干断层扫描（OCT）进行了描述，但有关该患者人群视盘周围血管的资料却很少。我们的目的是评估除 OCT 测量的 RNFL 外，OCT 血管造影（OCT-A）在 IIH 患者视盘周围区域的发现。
本研究纳入了 19 例 IIH 患者的 38 只眼和 21 例健康对照者的 42 只眼。根据 Frisen 量表对视盘水肿进行分级。用 OCT 和 OCT-A 分别评估视盘周围 RNFL 和血管密度。
OCT 显示 RNFL 厚度增加，但与对照组相比，仅 IIH 患者的下方位置的 RNFL 厚度增加具有统计学意义。与对照组相比，视盘水肿的 IIH 患者的 OCT-A 测量的平均视盘周围血管密度显着降低（P <0.05）。
在 IIH 患者中，OCT-A 测量的视盘周围血管密度降低，这种降低可能是由于视盘水肿导致视盘周围轴突肿胀所致。但是，自动调节血管机制也可能在视盘周围血管密度降低中起作用。
