Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
Am J Ophthalmol. 2019 Sep;205:43-49. doi: 10.1016/j.ajo.2019.03.028. Epub 2019 Apr 4.
To compare choroidal vascularity index (CVI) in patients with arteritic anterior ischemic optic neuropathy (A-AION), nonarteritic anterior ischemic optic neuropathy (NA-AION), and control subjects.
Retrospective cross-sectional study.
This study was conducted at the Ophthalmology Unit of the S.Orsola-Malpighi University Hospital (Bologna, Italy). Macular and optic nerve head optical coherence tomography (OCT) scans of 20 patients with A-AION secondary to giant cell arteritis (biopsy-proven), 20 patients with NA-AION, and 20 control subjects were acquired with Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany). Images were binarized using ImageJ software, and total choroid area (TCA), luminal area (LA), and stromal area (SA) were segmented. The main outcome measure was CVI, defined as the ratio of LA to TCA.
Patients with A-AION showed a significantly lower macular and peripapillary CVI compared to both patients with NA-AION (respectively, 67.17 ± 2.35 vs 69.66 ± 4.18, P = .048; 63.51 ± 3.29 vs 67.67 ± 3.07, P < .001) and control subjects (respectively, 67.17 ± 2.35 vs 70.00 ± 2.95, P = .021; 63.51 ± 3.29 vs 68.69 ± 3.19, P = .002). Conversely, no significant difference in macular and peripapillary CVI was found between patients with NA-AION and controls (respectively, P = .942 and P = .570). After adjustment for age, the difference of peripapillary CVI among groups remained statistically significant (P < .001), while the difference in macular CVI did not (P = .060).
Macular and peripapillary CVI are reduced in patients with A-AION. These parameters may be useful to quantitatively evaluate choroidal vascular dysfunction in A-AION, serving as a new additional diagnostic tool to distinguish A-AION from NA-AION.
比较巨细胞动脉炎相关性前部缺血性视神经病变（A-AION）、非巨细胞动脉炎相关性前部缺血性视神经病变（NA-AION）患者及对照组的脉络膜血管指数（CVI）。
回顾性横断面研究。
该研究在意大利博洛尼亚圣奥尔索拉-马焦雷大学医院（S.Orsola-Malpighi University Hospital）眼科病房进行。使用海德堡 Spectralis（Heidelberg Engineering，德国海德堡）对 20 例经活检证实为巨细胞动脉炎的 A-AION 患者、20 例 NA-AION 患者和 20 例对照组患者的黄斑区和视神经头光学相干断层扫描（OCT）图像进行采集。使用 ImageJ 软件对图像进行二值化处理，并对脉络膜总面积（TCA）、管腔面积（LA）和基质面积（SA）进行分割。主要观察指标为 CVI，定义为 LA 与 TCA 的比值。
与 NA-AION 患者（分别为 67.17 ± 2.35 对 69.66 ± 4.18，P =.048；63.51 ± 3.29 对 67.67 ± 3.07，P <.001）和对照组（分别为 67.17 ± 2.35 对 70.00 ± 2.95，P =.021；63.51 ± 3.29 对 68.69 ± 3.19，P =.002）相比，A-AION 患者的黄斑区和视盘周围 CVI 显著降低。然而，NA-AION 患者与对照组之间的黄斑区和视盘周围 CVI 无显著差异（分别为 P =.942 和 P =.570）。在校正年龄后，各组间视盘周围 CVI 的差异仍具有统计学意义（P <.001），而黄斑区 CVI 的差异无统计学意义（P =.060）。
A-AION 患者的黄斑区和视盘周围 CVI 降低。这些参数可能有助于定量评估 A-AION 脉络膜血管功能障碍，作为一种新的附加诊断工具，可用于区分 A-AION 和 NA-AION。
