Department of Ophthalmology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
Medizinische Fakultat, Ludwig-Maximilians-Universitat Munchen, Munich, Germany.
Br J Ophthalmol. 2020 Aug;104(8):1109-1113. doi: 10.1136/bjophthalmol-2019-314096. Epub 2019 Nov 19.
Optic disc drusen (ODD) can cause retinal nerve fibre layer (RNFL) defects with progressive visual field (VF) loss. Microvascular changes are discussed as a cause. We measured the vessel density (VD) of the optic disc in ODD using optical coherence tomography angiography and compared it with a normal population. Another intent was to determine the sensitivity and correlations in comparison with functional (VF) and structural parameters (RNFL, minimum rim width (MRW), ganglion cell complex (GCC)).
We analysed the VD of 25 patients with ODD and an age-matched control population including 25 healthy participants using AngioVue (Optovue, Fremont, CA, USA). We obtained data about RNFL, GCC, Bruch's membrane opening MRW (Spectralis HRA & OCT; Heidelberg Engineering, Germany) and VF (standard automated perimetry; SITA 24-2). Low image quality and pathologies interfering with the diagnostics were excluded. Parametric data were analysed using the t-test and non-parametric values using the Mann-Whitney U test. Linear regression analysis was used to determine correlations using the Bravais-Pearson test.
The VD was significantly reduced in the ODD group especially the peripapillary capillary VD (n=45 vs 50 eyes; mean 43.15% vs 51.70%). Peripapillary RNFL thickness correlated with the VD significantly (r=0.902 (n=44), 0.901 (n=44), 0.866 (n=45)). The RNFL analysis showed a reduction in ODD, especially the superior hemisphere (mean 107 µm, 129 µm; 49 vs 50 eyes). The GCC was significantly lower in the ODD group (n=38 vs 40; mean 87 µm vs 98 µm). Positive correlation between the VD and the GCC was significant (n=37, r=0.532). There is a significant negative correlation (n=19; r=-0.726) between the VD and the pattern standard deviation (PSD).
This study reveals significant peripapillary microvascular changes in patients with ODD correlating with the RNFL and GCC reduction. There is a negative correlation between the PSD and the VD.
视盘玻璃膜疣 (ODD) 可导致视网膜神经纤维层 (RNFL) 缺陷，并伴有进行性视野 (VF) 损失。微血管变化被认为是其病因之一。我们使用光相干断层扫描血管造影术 (OCTA) 测量 ODD 患者视盘的血管密度 (VD)，并与正常人群进行比较。另一个目的是确定与功能 (VF) 和结构参数 (RNFL、最小 rim 宽度 (MRW)、神经节细胞复合体 (GCC)) 相比，其敏感性和相关性。
我们使用 AngioVue (Optovue, Fremont, CA, USA) 分析了 25 例 ODD 患者和年龄匹配的对照组（包括 25 名健康参与者）的 VD。我们获得了关于 RNFL、GCC、Bruch 膜开口 MRW（Spectralis HRA & OCT；Heidelberg Engineering, Germany）和 VF（标准自动视野计；SITA 24-2）的数据。排除图像质量低和干扰诊断的病变。使用 t 检验分析参数数据，使用 Mann-Whitney U 检验分析非参数值。使用 Bravais-Pearson 检验进行线性回归分析以确定相关性。
ODD 组的 VD 明显降低，尤其是视盘周围毛细血管 VD（n=45 对 50 只眼；平均 43.15%对 51.70%）。视盘周围 RNFL 厚度与 VD 显著相关（r=0.902（n=44），0.901（n=44），0.866（n=45））。ODD 患者的 RNFL 分析显示，RNFL 减少，尤其是上半球（平均 107 μm，129 μm；49 对 50 只眼）。ODD 组的 GCC 明显较低（n=38 对 40；平均 87 μm 对 98 μm）。VD 与 GCC 之间存在显著的正相关（n=37，r=0.532）。VD 与模式标准差（PSD）之间存在显著的负相关（n=19；r=-0.726）。
本研究显示 ODD 患者视盘周围存在明显的微血管变化，与 RNFL 和 GCC 减少相关。PSD 与 VD 呈负相关。
