Hong Kong Eye Hospital (JCC, JKHL, CKMC), Hong Kong, China; Department of Ophthalmology and Visual Sciences (JCC, NCYC, CYC, JKHL, CKMC), the Chinese University of Hong Kong, Hong Kong, China; and Department of Ophthalmology and Visual Sciences (NCYC), the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China.
J Neuroophthalmol. 2021 Dec 1;41(4):e470-e482. doi: 10.1097/WNO.0000000000001106.
The purpose of this study is to quantitatively compare the peripapillary vessel density (PPVD), measured with optical coherence tomography angiography (OCT-A), between acute nonarteritic anterior ischemic optic neuropathy (NAION) and other causes of disc swelling ("others").
In this prospective comparative case series, patients with unilateral disc swelling due to acute NAION (n = 7) and "others" (n = 7) underwent OCT-A scanning of the optic nerve head with a swept-source OCT (Triton DRI-OCT), in addition to functional assessment. OCT-A images were analyzed using an automated customized MATLAB program. Comparison was made between total and 6 sectoral PPVD (radial peripapillary capillary [RPC] and choroid layers) of affected and fellow eyes; and between the 2 groups' affected eyes. Five NAION patients had repeated assessments at 1, 3, and 6 months.
Acute NAION eyes had a significantly lower total and superonasal PPVD (both layers) compared to fellow eyes. No such difference was observed in "others" group for the RPC layer. NAION eyes also had significantly lower total RPC PPVD than affected eyes in the "others" group. Over 6 months, NAION eyes had persistently lower RPC PPVD compared to fellow eyes but the reduced choroidal PPVD resolved by 1 month.
The study demonstrated reduced superonasal and total RPC PPVD in acute NAION, which persisted over 6 months. Because there is currently no single diagnostic test for NAION, use of OCT-A images to analyze RPC PPVD may potentially help distinguish acute NAION from other causes of disc swelling by quantitatively demonstrating capillary dropout in the RPC layer.
本研究旨在通过光学相干断层扫描血管造影（OCT-A）定量比较急性非动脉炎性前部缺血性视神经病变（NAION）和其他原因引起的视盘肿胀（“其他”）的视盘周围血管密度（PPVD）。
在这项前瞻性病例对照系列研究中，对单侧因急性 NAION（n = 7）和“其他”（n = 7）导致视盘肿胀的患者进行视神经头 OCT-A 扫描，使用扫频源 OCT（Triton DRI-OCT），除了功能评估外。使用自动定制的 MATLAB 程序分析 OCT-A 图像。比较受影响和对侧眼的总和 6 个扇形 PPVD（视盘周围毛细血管[RPC]和脉络膜层）；并比较两组受影响眼之间的差异。5 名 NAION 患者在 1、3 和 6 个月时进行了重复评估。
急性 NAION 眼的总和超鼻上 PPVD（两层）均明显低于对侧眼。在“其他”组中，RPC 层未观察到这种差异。NAION 眼的总 RPC PPVD 也明显低于“其他”组的受影响眼。在 6 个月内，NAION 眼的 RPC PPVD 持续低于对侧眼，但减少的脉络膜 PPVD 在 1 个月内得到解决。
该研究表明急性 NAION 存在超鼻上和总 RPC PPVD 减少，持续 6 个月以上。由于目前尚无 NAION 的单一诊断测试，因此使用 OCT-A 图像分析 RPC PPVD 可能有助于通过定量证明 RPC 层中的毛细血管丢失来区分急性 NAION 与其他原因引起的视盘肿胀。
