Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
Pediatric Neurology Department, Ankara Training and Research Hospital, Ankara, Turkey.
Photodiagnosis Photodyn Ther. 2023 Jun;42:103608. doi: 10.1016/j.pdpdt.2023.103608. Epub 2023 May 16.
The aim of this study was to evaluate retinal structural and microvascular alterations using optical coherence tomography-angiography (OCTA) in pediatric idiopathic intracranial hypertension (IIH) patients with regressed papilledema.
This study included 40 eyes of 21 IIH patients and 69 eyes of 36 healthy controls. Radial peripapillary capillary (RPC) vessel density and peripapillary retinal nerve fiber layer (RNFL) thickness were evaluated by XR Avanti AngioVue OCTA (Optovue, Fremont, CA, USA). The data were obtained from measurement zones that are automatically divided into two equal hemispheres (superior and inferior) and eight quadrants (superior-temporal, superior-nasal, inferior-temporal, inferior-nasal, nasal-superior, nasal-inferior, temporal-superior, temporal-inferior). Initial cerebrospinal fluid (CSF) pressure, grade of papilledema, and duration of follow-up were recorded.
There were significant differences in RPC vessel densities and RNFL thicknesses between the study groups (p ˃ 0.05). Significantly higher RPC vessel density measurements were observed in the patient group for the whole image, peripapillary, inferior-hemi, and whole nasal quadrants (p < 0.05). Except for the temporal-superior, temporal-inferior, inferior-temporal, and superior-temporal quadrants, the RNFL in all regions was significantly thicker in the IIH group than in the control group (p ˂ 0.001).
RNFL thickness and RPC vessel density were significantly different between the IIH patient and control groups, suggesting that retinal microvascular and subclinical structural changes that were potentially secondary to CSF pressure can persist after the resolution of papilledema. However, our results should be confirmed by further longitudinal studies investigating the progress of these alterations to determine their effects on peripapillary tissues.
本研究旨在评估视网膜结构和微血管改变，使用光相干断层扫描血管造影（OCTA）在儿童特发性颅内高压（IIH）患者与视盘水肿消退。
本研究包括 21 例 IIH 患者的 40 只眼和 36 名健康对照者的 69 只眼。通过 XR Avanti AngioVue OCTA（Optovue，弗里蒙特，CA，美国）评估视网膜神经纤维层（RNFL）厚度和视网膜神经纤维层（RNFL）厚度。数据是从自动分为两个相等的半球（上和下）和八个象限（上颞、上鼻、下颞、下鼻、鼻上、鼻下、颞上、颞下）的测量区获得的。记录初始脑脊液（CSF）压力、视盘水肿程度和随访时间。
研究组间视网膜神经纤维层（RNFL）厚度和视网膜神经纤维层（RNFL）厚度有显著差异（p > 0.05）。在整个图像、视盘周围、下半球和整个鼻象限，患者组的视网膜毛细血管密度测量值显著升高（p < 0.05）。除颞上、颞下、下颞和上颞象限外，IIH 组各区域的 RNFL 均明显厚于对照组（p < 0.001）。
IIH 患者和对照组之间的 RNFL 厚度和视网膜毛细血管密度有显著差异，提示视网膜微血管和潜在的亚临床结构改变可能继发于 CSF 压力，在视盘水肿消退后仍能持续存在。然而，我们的结果应通过进一步的纵向研究来证实，这些研究旨在调查这些改变的进展，以确定它们对视盘周围组织的影响。
