Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Ophthalmol. 2021 May;99(3):288-298. doi: 10.1111/aos.14577. Epub 2020 Aug 24.
This study aimed to evaluate parafoveal and peripapillary microvascular alterations in eyes with optic neuritis (ON) along with their fellow eyes compared to healthy control eyes using optical coherence tomography angiography (OCT-A).
We included 31 ON-affected eyes and 31 fellow eyes of 31 patients who had experienced unilateral ON and 33 eyes of 33 healthy controls in this exploratory retrospective cross-sectional study. Optical coherence tomography angiography (OCT-A) was used to generate microvascular structural images and quantify the vessel density of the superficial retinal capillary plexus (SRCP), the deep retinal capillary plexus (DRCP) and radial peripapillary capillary (RPC) segments. We used the Kruskal-Wallis test for the comparison of OCT-A results between the three groups and generalized estimating equation models for the pairwise comparisons.
There were significant differences of SRCP (p = 0.0003) and RPC segment (p < 0.0001) vessel densities between the three groups. Specifically, there was a reduction in parafoveal and peripapillary vessel density in the ON-affected eyes compared to fellow eyes (SRCP, estimates, -1.97, 95% confidence interval [CI], -3.07, -0.87; RPC, -6.95, 95% CI, -8.70, -5.19) and controls (SRCP, -3.15, 95% CI, -4.61, -1.69; RPC, -8.66, 95% CI, -10.55, -6.76). The superior sector of the RPC segments vessel density in the fellow eyes was decreased compared to the controls (-4.93, 95% CI, -8.07, -1.80).
The results of this study suggest that microvascular changes occur in both the affected eye and unaffected fellow eye after a unilateral ON episode. Future studies are needed to clarify the clinical implications of these findings.
本研究旨在通过光学相干断层扫描血管造影(OCT-A)评估视神经炎(ON)患者患眼及对侧眼与健康对照眼的旁中心和视盘周围微血管改变。
本探索性回顾性病例对照研究纳入了 31 例单侧 ON 患者的 31 只患眼、31 只对侧眼和 33 名健康对照者的 33 只眼。采用 OCT-A 生成微血管结构图像并定量分析浅层视网膜毛细血管丛(SRCP)、深层视网膜毛细血管丛(DRCP)和放射状视盘周围毛细血管(RPC)节段的血管密度。采用 Kruskal-Wallis 检验比较三组间 OCT-A 结果,采用广义估计方程模型进行两两比较。
三组间 SRCP(p=0.0003)和 RPC 节段(p<0.0001)的血管密度存在显著差异。具体而言,与对侧眼相比,患眼的旁中心和视盘周围血管密度降低(SRCP,估计值,-1.97,95%置信区间[CI],-3.07,-0.87;RPC,-6.95,95% CI,-8.70,-5.19)和健康对照者(SRCP,-3.15,95% CI,-4.61,-1.69;RPC,-8.66,95% CI,-10.55,-6.76)。与健康对照者相比,对侧眼的 RPC 节段上方血管密度降低(-4.93,95% CI,-8.07,-1.80)。
单侧 ON 发作后,患眼和对侧眼均出现微血管改变。需要进一步研究阐明这些发现的临床意义。