Peripapillary and parafoveal microvascular changes in eyes with optic neuritis and their fellow eyes measured by optical coherence tomography angiography: an Exploratory Study

Lee, Ga-In; Park, Kyung-Ah; Oh, Sei Yeul; Min, Ju-Hong; Kim, Byoung Joon

doi:10.1111/aos.14577

Cited by 9 publications

(6 citation statements)

References 44 publications

(70 reference statements)

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“…Therefore, we suggest that inflammation may also affect small vessels near the optic disc. Indeed, peripapillary blood flow is also reduced in patients with optic neuritis ( 47 – 49 ). However, we cannot exclude possible papilledema as eyes afflicted with optic neuritis also showed decreased blood flow ( 48 ).…”

Section: Discussionmentioning

confidence: 99%

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

Zhang

Xiao

et al. 2021

Front. Med.

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Background: Vogt-Koyanagi-Harada (VKH) disease is a multisystem autoimmune disorder which could induce bilateral panuveitis involving the posterior pole and peripheral fundus. Optical coherence tomography angiography (OCTA) provides several advantages over traditional fluorescence angiography for revealing pathological abnormalities of the retinal vasculature. Until recently, however, the OCTA field of view (FOV) was limited to 6 × 6 mm2 scans.Purpose: This study examined retinal vasculature and choriocapillaris abnormalities across multiple regions of the retina (15 × 9 mm2 wide field, macular, peripapillary regions) among acute and convalescent VKH patients using a novel widefield swept-source OCTA (WSS-OCTA) device and assessed correlations between imaging features and best-corrected visual acuity (BCVA).Methods: Twenty eyes of 13 VHK disease patients in the acute phase, 30 eyes of 17 patients in the convalescent phase, and 30 eyes of 15 healthy controls (HCs) were included in this study. Vascular length density (VLD) in superficial and deep vascular plexuses (SVP, DVP), vascular perfusion density (VPD) in SVP, DVP, and choriocapillaris (CC), and flow voids (FV) in CC were measured across multiple retinal regions via WSS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec Inc., USA) using the 15 × 9 mm2 scan pattern centered on the fovea and quantified by ImageJ.Results: Compared to HCs, acute phase VKH patients exhibited significantly reduced SVP-VLD, SVP-VPD, and CC-VPD across multiple retinal regions (all p < 0.01). Notably, the FV area was more extensive in VKH patients, especially those in the acute phase (p < 0.01). These changes were reversed in the convalescent phase. Stepwise multiple linear regression analysis demonstrated that macular DVP-VLD and macular CC-VPD were the best predictive factors for BCVA in the acute and convalescent VKH groups.Conclusion: The wider field of SS-OCAT provides more comprehensive and detailed images of the microvasculature abnormalities characterizing VKH disease. The quantifiable and layer-specific information from OCTA allows for the identification of sensitive and specific imaging markers for prognosis and treatment guidance, highlighting WSS-OCTA as a promising modality for the clinical management of VKH disease.

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Section: Discussionmentioning

confidence: 99%

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

Zhang

Xiao

et al. 2021

Front. Med.

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“…The evolution of OCT led to OCT angiography (OCTA) that allows quantitation of capillary perfusion in the macular and optic disc areas. The high sensitivity and specificity of OCTA has enabled the measurement of retinal capillary density and whole image vessel density (VD) in ocular diseases such as glaucoma [ 13 ], optic neuritis [ 14 , 15 ], and several optic neuropathies [ 16 , 17 ]. With the help of OCTA technology, we recently described a reduction of retinal VD and thinning of the inner intra-retinal layers in TAO patients compared with controls [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Peripapillary structural and microvascular alterations in early dysthyroid optic neuropathy

Yang

Ding

et al. 2022

Eye and Vis

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Background To explore the changes in blood supply and structure around the optic nerve head (ONH) in thyroid-associated ophthalmopathy (TAO) patients with suspected dysthyroid optic neuropathy (DON). Methods TAO patients [19 with DON; 24 non-DON (NDON); 20 with equivocal DON (EDON)], and 34 control subjects were examined. Optical coherence tomography angiography (OCTA) was used to obtain peripapillary retinal nerve fiber layer (p-RNFL) and vessel density parameters, including the ONH whole image vessel density (ONH-wiVD) and the radial peripapillary capillary vessel density (RPC-VD) in early DON. Results Although there were no differences in p-RNFL thickness among the groups, there were differences in the ONH-wiVD of each grid section and the RPC-VD in all areas (P < 0.01). Compared with healthy controls, the EDON eyes had significantly lower RPC-VDs in all aeras (P < 0.05).The peripapillary region was further divided into eight sectors, and the RPC-VD in the temporal upper, superior temporal, and temporal lower sectors in the EDON group were significantly lower than in the controls. The visual impairment was closely related to the loss of peripapillary capillary vessel density. Univariate correlation analysis showed that the ONH-wiVD and RPC-VD of the TAO groups were negatively correlated with the intraocular pressure (r = − 0.296, P = 0.006; r = − 0.258, P = 0.016 respectively). Conclusions EDON patients had significantly lower ONH-wiVD and RPC-VD than control subjects, and the temporal and upper VDs were more likely to be affected in the early stage of TAO. The combined use of spectral domain optical coherence tomography and OCTA technologies offer a new method for early diagnosis of suspected DON patients.

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“…If MvD is instead taken as a sign of choroidal vascular insufficiency, as shown by Jo et al in glaucoma [ 4 ], it is not entirely unreasonable to assume that decreased GCIP thickness in all sectors at 6 months in the MvD+ group is the loss of ganglion cells from more severely impaired perfusion. Whether choroidal vascular insufficiency, if present in optic neuritis, is a contributing factor in the development of the disease or a product of extensive damage from inflammation needs to be studied further [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Peripapillary choroidal microvasculature dropout is associated with poor prognosis in optic neuritis

et al. 2023

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Purpose To identify peripapillary choroidal microvasculature dropout (MvD) in eyes with optic neuritis and its association with longitudinal changes in retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIP) thicknesses following diagnosis. Methods A total of 48 eyes with optic neuritis was evaluated to identify the presence of peripapillary choroidal MvD, defined as a focal capillary loss with no visible microvascular network in choroidal layer, using optical coherence tomography (OCT) angiography (OCTA). Patients were divided based on the presence of MvD. OCT and standard automated perimetry (SAP) conducted at 1, 3 and 6 months follow-up were analyzed. Results MvD was identified in 20 of 48 eyes (41.7%) with optic neuritis. MvD was most commonly found in the temporal quadrant (85.0%), and peripapillary retinal vessel density in the temporal quadrant was significantly lower in eyes with MvD (P = 0.012). At 6 months follow-up, optic neuritis eyes with MvD showed significantly thinner GCIP in superior, superotemporal, inferior and inferotemporal sectors (P<0.05). No significant difference was noted in SAP parameters. The presence of MvD was significantly associated with thinner global GCIP thickness at 6 months follow-up (OR 0.909, 95% CI 0.833–0.992, P = 0.032). Conclusion Optic neuritis showed peripapillary choroidal microvascular impairment in the form of MvD. MvD was associated with structural deterioration at macular GCIP. Further studies are necessary to identify the causal relationship between microvascular impairment and retinal nerve fiber layer damage in optic neuritis.

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Peripapillary and parafoveal microvascular changes in eyes with optic neuritis and their fellow eyes measured by optical coherence tomography angiography: an Exploratory Study

Cited by 9 publications

References 44 publications

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

Microvasculature Features of Vogt-Koyanagi-Harada Disease Revealed by Widefield Swept-Source Optical Coherence Tomography Angiography

Peripapillary structural and microvascular alterations in early dysthyroid optic neuropathy

Peripapillary choroidal microvasculature dropout is associated with poor prognosis in optic neuritis

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