Montorio Daniela, Cennamo Gilda, Carotenuto Antonio, Petracca Maria, Brescia Morra Vincenzo, Costagliola Ciro
Eye Clinic, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy.
Eye Clinic, Department of Public Health, University of Naples Federico II, Naples, Italy.
Front Med (Lausanne). 2022 Oct 24;9:1032514. doi: 10.3389/fmed.2022.1032514. eCollection 2022.
The identification of non-invasive biomarkers to investigate and monitor retinal structural and vascular changes in multiple sclerosis (MS) represents an interesting source of debate. Until now optical coherence tomography angiography (OCTA) evaluated the foveal avascular zone (FAZ) and areas of retinal non-perfusion only in the macular region in MS patients. It could be interesting to identify possible biomarkers, useful in assessing the ischemic areas also in the near peripheral retina, since FAZ enlargement and the areas of peripheral retinal non-perfusions share common pathogenic processes. In this cross-sectional study, we investigated the correlation between the FAZ area and retinal vessel density (VD) in the near peripheral retina by new wide-field optical coherence tomography angiography (OCTA) in patients affected by relapsing-remitting multiple sclerosis (RR-MS). Moreover, we compared the FAZ area and the VD of superficial and deep capillary plexuses in the fovea region and in the near peripheral retina (6.4 × 6.4 mm) between RR-MS patients and healthy controls by means of a Solix full-range OCTA. Last, we also detected the changes in structural OCT parameters (ganglion cell complex and retinal nerve fiber layer). Thirty-three eyes of 33 RR-MS patients and 35 eyes of 35 healthy controls were enrolled. RR-MS patients showed a lower VD in the superficial capillary plexus and a significant increase in the FAZ area compared with controls. The deep capillary plexus revealed a reduced VD although not statistically significant in patients with respect to controls. In the patients' group, the FAZ area showed significantly negative correlations with VD of superficial capillary plexuses in the foveal and whole region, while the FAZ area did not negatively correlate with the VD of the deep capillary plexus. The significant correlations among OCTA parameters could demonstrate the FAZ area as a possible biomarker for assessing the perfusion status in the near peripheral retina, useful in RR-MS management. These findings could confirm the role of vascular dysfunction in the pathogenetic mechanisms of MS.
识别用于研究和监测多发性硬化症（MS）视网膜结构和血管变化的非侵入性生物标志物是一个备受争议的有趣话题。到目前为止，光学相干断层扫描血管造影（OCTA）仅评估了MS患者黄斑区的无血管区（FAZ）和视网膜无灌注区域。识别可能有助于评估近周边视网膜缺血区域的生物标志物可能会很有意思，因为FAZ扩大和周边视网膜无灌注区域具有共同的致病过程。在这项横断面研究中，我们通过新型广角光学相干断层扫描血管造影（OCTA）研究了复发缓解型多发性硬化症（RR-MS）患者近周边视网膜FAZ面积与视网膜血管密度（VD）之间的相关性。此外，我们通过Solix全范围OCTA比较了RR-MS患者和健康对照在黄斑区和近周边视网膜（6.4×6.4 mm）中浅层和深层毛细血管丛的FAZ面积和VD。最后，我们还检测了结构OCT参数（神经节细胞复合体和视网膜神经纤维层）的变化。纳入了33例RR-MS患者的33只眼和35例健康对照的35只眼。与对照组相比，RR-MS患者浅层毛细血管丛的VD较低，FAZ面积显著增加。深层毛细血管丛的VD降低，尽管与对照组相比在患者中无统计学意义。在患者组中，FAZ面积与黄斑区和整个区域浅层毛细血管丛的VD呈显著负相关，而FAZ面积与深层毛细血管丛的VD无负相关。OCTA参数之间的显著相关性可以证明FAZ面积可能是评估近周边视网膜灌注状态的生物标志物，对RR-MS的管理有用。这些发现可以证实血管功能障碍在MS发病机制中的作用。
