The blood perfusion changes of peripapillary and macular vessels in patients with nonarteritic anterior ischemic optic neuropathy / 中华眼底病杂志

ABSTRACT

Objective To observe the blood perfusion changes ofperipapillary and macular vessels in patients with nonarteritic anterior ischaemic optic neuropathy (NAION).Methods Retrospective cohort study.Thirty-six eyes (19 affected eyes and 17 fellow eyes) of 19 patients with NAION diagnosed in People's Hospital of Wuhan University from November 2017 to January 2019 were included in this study.There were 1 0 males and 9 females,with the mean age of 55.05 ± 7.11 years.Forty eyes of 20 normal subjects matched with NAION patients were included as controls.BCVA,fundus color photography,SD-OCT and OCT angiography were performed in normal controls and repeated in NAION affected eyes at 1-2 weeks,1-2 months,3-5 months intervals.OCT quantitative measurementsaverage retinal nerve fiber layer thickness (aRNFL) of the disc and its superior values (sRNFL) and the inferior values (iRNFL),average ganglion cell complex thickness (aGCC) in macular region and its superior values (sGCC) and the inferior values (iGCC).OCTA quantitative measurementsaverage radial peripapillary capillary density (aRPC) and its superior values (sRPC) and the inferior values (iRPC),average vascular density of superficial retina (aSVD) in macular region and its superior values (sSVD) and the inferior values (iSVD),average vascular density of deep layer retina (aDVD),areas of foveal avascular zone (FAZ).The differences of OCT and OCTA quantitative measurements between NAION eyes and the fellow eyes and normal controls were comparatively analyzed.Independent sample t test,paired sample t test or nonparametric rank sum test were performed for comparison among three groups.Pearson or Spearman correlation analysis were used to analyze the correlation between RNFL and RPC,GCC and SVD,RNFL and GCC,RPC and SVD.Results At baseline,the aRNFL,aRPC and aDVD of NAION patients were significantly higher than those of normal controls.Compared with the fellow eyes,the aRNFL increased significantly and the aRPC decreased significantly in NAION affected eyes.The overall differences of aRNFL,aRPC,aGCC and aSVD at four intervals within NAION affected eyes were statistically significant (P＜0.05).The average sRNFL,sRPC,sGCC and sSVD at 1-2 months interval were significantly lower than the average iRNFL,iRPC,iGCC and iSVD (P＜0.05).Correlation analysis:at 1-2 months interval,aGCC was positively correlated with aSVD (r=0.482,P=0.037);at 3-5 months interval,aRNFL was positively correlated with aRPC (r=0.631,P=0.037).Conclusion There is a sectorial reduction of vascular density of peripapillary RPC and macular SVD with the disease progression of NAION.