Sheremet N L, Shmelkova M S, Andreeva N A, Zhorzholadze N V, Fomin A V, Krylova T D, Tsygankova P G
Research Institute of Eye Diseases, Moscow, Russia.
Tradomed Invest JSC, Moscow, Russia.
Vestn Oftalmol. 2020;136(4. Vyp. 2):171-182. doi: 10.17116/oftalma2020136042171.
To investigate the features of various parameters of the density of retinal blood vessels, optic nerve head (ONH) and peripapillary region in hereditary optic neuropathy (HON) patients revealed with optical coherence tomography angiography (OCTA).
The study included 29 HON patients divided into three groups based on symptoms duration (less than 1 year; 1-5 years, more than 5 years) and visual acuity (0.5-1.0; 0.04-0.4; 0.03 and lower). Relative macular, optic disc and peripapillary vessel density (VD, %) was assessed by OCTA (xR Avanti, Optovue Inc., USA).
Significant progressive VD reduction in superficial capillary plexus (SCP) was detected in all parafovea sectors and in the temporal sector of perifovea over the course of disease progression. No significant differences of these parameters were found in correlation with visual acuity. Patients with VA of 0.5-1.0 turned out to have greater VD in deep capillary plexus (DCP), whereas no differences were found in relation to the duration of HON. A strong significant correlation between the SCP and DCP VD only in central foveal area was revealed in all groups depending on the VA and symptoms duration. Over the course of HON progression, VD in the temporal sector and in temporal segments of superior and inferior sectors has gradually reduced. In patients with VA of 0.5-1.0, the retinal nerve fibers layer (RNFL) thickness in the temporal sector and optic nerve VD was notably greater compared to patients with lower VA. The most significant correlation was established between VA and structural changes (K=0.75, <0.001) and VD in the temporal sector (=0.57-0.61, <0.001).
The obtained data suggest that derivative microvascular changes play an active role in the clinical progression of the disease.
探讨光学相干断层扫描血管造影（OCTA）显示的遗传性视神经病变（HON）患者视网膜血管密度、视神经乳头（ONH）和视乳头周围区域各项参数的特征。
该研究纳入29例HON患者，根据症状持续时间（小于1年；1 - 5年，大于5年）和视力（0.5 - 1.0；0.04 - 0.4；0.03及更低）分为三组。通过OCTA（xR Avanti，美国Optovue公司）评估相对黄斑、视盘和视乳头周围血管密度（VD，%）。
在疾病进展过程中，所有黄斑旁区域和中央凹周围颞侧区域的浅表毛细血管丛（SCP）中均检测到VD显著进行性降低。这些参数与视力无显著差异。视力为0.5 - 1.0的患者在深部毛细血管丛（DCP）中的VD更高，而与HON病程无关。根据视力和症状持续时间，所有组仅在中央凹区域显示SCP和DCP的VD之间存在强显著相关性。在HON进展过程中，颞侧区域以及上、下象限颞侧节段的VD逐渐降低。视力为0.5 - 1.0的患者与视力较低的患者相比，颞侧区域的视网膜神经纤维层（RNFL）厚度和视神经VD明显更大。视力与结构变化（K = 0.75，<0.001）以及颞侧区域的VD（= 0.57 - 0.61，<0.001）之间建立了最显著的相关性。
所获得的数据表明，衍生的微血管变化在疾病的临床进展中起积极作用。
