Qian Xian-Zhe, Chen Cheng, Li Hong-Liang, Zhong Lei, Wei Hong, Ge Qian-Min, Hu Jin-Yu, Hong Qi, Wang Xiao-Yu, Zeng Yan-Mei, Chen Xu, Wang Yi-Xin, Pei Chong-Gang, Shao Yi
Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.
Sci Rep. 2025 Jul 1;15(1):22143. doi: 10.1038/s41598-025-08501-5.
Moyamoya disease (MMD) is a structural abnormality of the cerebral vasculature characterized by cerebral ischemia, and is rare but its incidence is increasing. Digital subtraction angiography (DSA) of the brain is the primary means of diagnosing and evaluating this disease. But its high price and invasiveness limit its use as a monitoring tool for disease progression. As a non-invasive test for ophthalmic disorders, the optical coherence tomography angiography (OCTA) is widely used. In addition to ophthalmic diseases, OCTA has also been used in some neurological diseases. The aim of this study was to assess fundus changes in patients with MMD by OCTA and to investigate whether these changes could be a diagnostic and assessment marker for MMD. This study evaluated cerebral vessels, superficial macular capillary vessel density (SMC-VD) and macular retinal thickness (MRT) in subjects in the non-operated group (nGO), operated group (OG) and healthy controls (HC) using DSA, OCTA and other techniques. Analyses of variance (ANOVA) and Bonferroni post hoc analysis were used to calculate statistical differences between the three groups. Correlations between SMC-VD and MRT were assessed using Pearson correlation analysis. In addition, the ability of the SMC-VD and the MRT to distinguish MMD from HC was analyzed using receiver operating characteristic (ROC) curves. We found that the SMC-VD and MRT in the nOG group were significantly lower than those in the HC group and had not returned to normal levels at one month postoperatively. In the nOG, the SMC-VD and MRT were positively correlated in the Full region (66 mm) and in the Inner region (33 mm), and in many subregions they showed high ability to distinguish MMD from HC. The above findings indicate significant reduction in the SMC-VD and the MRT in patients with MMD even in the absence of ocular clinical manifestation. Most importantly, SMC-VD and MRT have a strong ability to distinguish between MMD patients and HC, suggesting that OCTA, a relatively inexpensive and non-invasive method, is useful in assessing cerebrovascular changes in MMD patients.
烟雾病（MMD）是一种以脑缺血为特征的脑血管结构异常疾病，虽罕见但其发病率正在上升。脑部数字减影血管造影（DSA）是诊断和评估该疾病的主要手段。但其高昂的价格和侵入性限制了其作为疾病进展监测工具的应用。光学相干断层扫描血管造影（OCTA）作为一种用于眼科疾病的非侵入性检查方法被广泛使用。除眼科疾病外，OCTA也已应用于一些神经系统疾病。本研究旨在通过OCTA评估MMD患者的眼底变化，并研究这些变化是否可作为MMD的诊断和评估标志物。本研究使用DSA、OCTA及其他技术评估了未手术组（nGO）、手术组（OG）和健康对照组（HC）受试者的脑血管、黄斑表层毛细血管密度（SMC - VD）和黄斑视网膜厚度（MRT）。采用方差分析（ANOVA）和Bonferroni事后分析计算三组之间的统计学差异。使用Pearson相关分析评估SMC - VD与MRT之间的相关性。此外，使用受试者工作特征（ROC）曲线分析SMC - VD和MRT区分MMD与HC的能力。我们发现，nOG组的SMC - VD和MRT显著低于HC组，且术后1个月未恢复至正常水平。在nOG组中，全区域（6×6 mm）和内区域（3×3 mm）的SMC - VD与MRT呈正相关，并且在许多子区域它们显示出区分MMD与HC的高能力。上述发现表明，即使在没有眼部临床表现的情况下，MMD患者的SMC - VD和MRT也显著降低。最重要的是，SMC - VD和MRT具有很强的区分MMD患者与HC的能力，这表明OCTA这种相对廉价且非侵入性的方法可用于评估MMD患者的脑血管变化。
