Li Jin, Chen Yihong, Zhang Ying, He Zhiyong, Yu Huankai, Shi Ce, Shen Meixiao, Lu Fan
Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, China.
School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Front Neurol. 2022 Nov 14;13:1019959. doi: 10.3389/fneur.2022.1019959. eCollection 2022.
To assess macular and peripapillary vessel density and neurodegeneration in eyes with and without microcystic macular edema (MME) in neuromyelitis optica spectrum disorder (NMOSD) patients while investigating their association with visual impairment and disease disability.
This is a cross-sectional study. A total of 52 eyes from 29 NMOSD patients were recruited, including 8 eyes with MME from 7 patients. Optical coherence tomography angiography (OCTA) images were analyzed to quantify the radial papillary capillary density (RPCD), and the density of macular microvascular network in both the superficial retinal capillary plexus (SRCP) and the deep retinal capillary plexus (DRCP). Thicknesses of the neural retinal layers centered on the fovea and the optic nerve head were also collected by OCT. Best-corrected visual acuity (BCVA) and Expanded Disability Status Scale (EDSS) scores were assessed for all patients. Microvascular densities and retinal sublayer thicknesses were compared among groups, and correlations of these vascular and structural parameters with BCVA and EDSS scores were determined.
Patients with NMOSD and MME had significantly decreased visual acuity and worse EDSS score than patients without MME ( = 0.01 and 0.002, respectively). The vessel density in SRCP and RPCD were significantly lower in eyes with MME and ON compared to that of eyes with ON but without MME and eyes without MME or ON. Impairment of visual acuity and disease severity were significantly negatively associated with the reduction of SRCP vessel density and RPCD but were not related to DRCP vessel density.
MME were correlated with worse visual impairment and disability in NMOSD patients. Sparse SRCP vessel density and RPCD were observed in NMOSD MME eyes and correlated with worse BCVA and EDSS scores.
评估视神经脊髓炎谱系障碍（NMOSD）患者中有无微囊性黄斑水肿（MME）的眼睛的黄斑和视乳头周围血管密度及神经变性，同时研究它们与视力损害和疾病残疾的关系。
这是一项横断面研究。共纳入29例NMOSD患者的52只眼睛，其中7例患者的8只眼睛患有MME。分析光学相干断层扫描血管造影（OCTA）图像以量化放射状乳头毛细血管密度（RPCD），以及浅表视网膜毛细血管丛（SRCP）和深部视网膜毛细血管丛（DRCP）中黄斑微血管网络的密度。还通过OCT收集以黄斑中心凹和视神经乳头为中心的神经视网膜层厚度。评估所有患者的最佳矫正视力（BCVA）和扩展残疾状态量表（EDSS）评分。比较各组间的微血管密度和视网膜亚层厚度，并确定这些血管和结构参数与BCVA和EDSS评分的相关性。
与无MME的患者相比，患有NMOSD和MME的患者视力显著下降，EDSS评分更差（分别为P = 0.01和0.002）。与患有视神经炎（ON）但无MME的眼睛以及无MME或ON的眼睛相比，患有MME和ON的眼睛中SRCP和RPCD的血管密度显著降低。视力损害和疾病严重程度与SRCP血管密度和RPCD的降低显著负相关，但与DRCP血管密度无关。
MME与NMOSD患者更严重的视力损害和残疾相关。在NMOSD合并MME的眼睛中观察到SRCP血管密度和RPCD稀疏，且与更差的BCVA和EDSS评分相关。
