在急性非动脉炎性前部缺血性视神经病变及正常对侧眼的全反式光学相干断层扫描中观察到巨噬细胞样细胞的特征。

Characteristics of macrophage-like cells in acute nonarteritic anterior ischemic optic neuropathy and the normal fellow eyes on en face optical coherence tomography.

机构信息

Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Ophthalmology, Yidu People's Hospital, Yichang, China.

出版信息

Front Immunol. 2022 Dec 23;13:1095296. doi: 10.3389/fimmu.2022.1095296. eCollection 2022.

PURPOSE

To quantitatively analyze macrophage-like cells (MLCs) at the vitreoretinal interface (VRI) in acute nonarteritic anterior ischemic optic neuropathy (NAION) using en face swept-source optical coherence tomography (OCT).

METHODS

Twenty-five acute NAION eyes and 25 normal fellow eyes from 25 patients were included in the study. MLCs were visualized in a 3 μm 6 mm×6 mm en face OCT slab above the VRI centered on the optic nerve head (ONH). After semiautomatic binarization and quantification, we evaluated the MLC density between the two groups. We also investigated the relationship between MLC density and other OCT parameters, including the increase in peripapillary retinal nerve fiber layer (RNFL) thickness and loss of vessel density (VD) in radical peripapillary capillary (RPC).

RESULTS

The MLC density in the affected eye of the ONH was highly correlated with that in the fellow eye (r=0.612, p=0.001). The MLC density significantly increased in acute NAION eyes (NAION vs. normal, 11.97 ± 6.66 vs. 9.31 ± 6.10 cell/mm, p=0.028). In sectorial analysis, the increase in MLCs was mainly in the superior regions (4.13 ± 7.49 vs. 0.94 ± 5.21 cell/mm, p=0.001). The VD of RPC decreased significantly in the affected eyes (NAION vs. normal, 37.54 ± 5.25 vs. 40.56 ± 4.25, p=0.016), and the loss of RPC was predominantly in the superior sectors and the temporal sectors when compared to the inferior sectors and the nasal sectors, respectively (superior vs. inferior, -3.54 ± 6.71 vs. -0.37 ± 8.07, p=0.004; temporal vs. nasal, -2.69 ± 8.72 vs. -1.22 ± 6.06, p=0.005). The loss of RPC and the increase in MLC density were greater in affected sector corresponding to the visual field (VF) defect.

CONCLISION

MLCs located above the VRI increased significantly in acute NAION eyes, especially in subregions corresponding to VF defect, which provides clinical evidence supporting that the inflammatory response participates in the pathological process of NAION. The magnitude of the increase in MLCs corresponds to the RPC loss in the quadrant analysis.

目的

利用共焦激光扫描检眼镜（OCT）下的面扫源光学相干断层扫描（en face swept-source optical coherence tomography，en face SS-OCT）定量分析前部缺血性视神经病变（anterior ischemic optic neuropathy，AION）急性期视盘视网膜神经纤维层（retinal nerve fiber layer，RNFL）上方的脉络膜神经上皮层（retinal pigment epithelium，RPE）和脉络膜毛细血管（choriocapillaris，ChC）之间的巨噬细胞样细胞（macrophage-like cells，MLCs）。

方法

纳入 25 例 AION 患者（25 只患眼）和 25 例同年龄正常人（25 只正常眼），通过面扫 SS-OCT 在视盘上方 3μm 6mm×6mm 区域对 MLC 进行成像，以视盘为中心。进行半自动二值化和定量分析后，比较两组 MLC 密度。同时还研究了 MLC 密度与其他 OCT 参数之间的关系，包括视盘周围视网膜神经纤维层（peripapillary retinal nerve fiber layer，pRNFL）厚度的增加和视盘周围毛细血管（radical peripapillary capillary，RPC）中血管密度（vessel density，VD）的丧失。

结果

ONH 受累眼的 MLC 密度与对侧眼高度相关（r=0.612，p=0.001）。急性 AION 眼的 MLC 密度明显增加（AION 对正常，11.97±6.66 vs. 9.31±6.10 个细胞/mm，p=0.028）。扇形分析显示，MLCs 的增加主要在上方区域（4.13±7.49 vs. 0.94±5.21 个细胞/mm，p=0.001）。受累眼的 RPC VD 明显下降（AION 对正常，37.54±5.25 vs. 40.56±4.25，p=0.016），与下方和鼻侧象限相比，上方和颞侧象限的 RPC 丢失更为明显（分别为上侧与下侧，-3.54±6.71 vs. -0.37±8.07，p=0.004；颞侧与鼻侧，-2.69±8.72 vs. -1.22±6.06，p=0.005）。与视野（visual field，VF）缺损对应的受累象限中，RPC 的丢失和 MLC 密度的增加更为明显。