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Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy

PURPOSE: The hallmark of non-arteritic anterior ischemic optic neuropathy (NAION) is vascular compromise to the anterior optic nerve and thinning of the retinal nerve fiber layer (RNFL) and secondary degeneration of the retinal ganglion cell body or thinning of the ganglion cell complex (GCC). This...

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Autores principales: Pugazhendhi, Sangeethabalasri, Yu, Miaomiao, Zhou, Gabriella, Chen, Yuxuan, Wang, Ruikang, Liao, Yaping Joyce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877420/
https://www.ncbi.nlm.nih.gov/pubmed/36714135
http://dx.doi.org/10.3389/fmed.2022.1033838
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author Pugazhendhi, Sangeethabalasri
Yu, Miaomiao
Zhou, Gabriella
Chen, Yuxuan
Wang, Ruikang
Liao, Yaping Joyce
author_facet Pugazhendhi, Sangeethabalasri
Yu, Miaomiao
Zhou, Gabriella
Chen, Yuxuan
Wang, Ruikang
Liao, Yaping Joyce
author_sort Pugazhendhi, Sangeethabalasri
collection PubMed
description PURPOSE: The hallmark of non-arteritic anterior ischemic optic neuropathy (NAION) is vascular compromise to the anterior optic nerve and thinning of the retinal nerve fiber layer (RNFL) and secondary degeneration of the retinal ganglion cell body or thinning of the ganglion cell complex (GCC). This study investigates optical coherence tomography (OCT) and OCT Angiography (OCTA) changes in chronic NAION and identifies imaging biomarkers that best predict disease. METHODS: We performed a retrospective case-control study of 24 chronic NAION eyes (18 patients) and 70 control eyes (45 patients) to compare both whole-eye and regional OCT, OCTA, static perimetry measurements. OCT measurements were quantified automatically using commercial software, and OCTA was analyzed using custom MATLAB script with large vessel removal to measure 154 total parameters per eye. RESULTS: We confirmed that static perimetry mean deviation (MD) was significantly worse in chronic NAION (–13.53 ± 2.36) than control (–0.47 ± 0.72; P < 0.001) eyes, and NAION eyes had 31 μm thinner RNFL (control: 95.9 ± 25.8 μm; NAION: 64.5 ± 18.0, P < 0.001), and 21.8 μm thinner GCC compared with controls (control: 81.5 ± 4.4 μm; NAION: 59.7 ± 10.5, P < 0.001). Spearman correlation analysis of OCTA parameters reveal that vessel area density (VAD) and flux are highly correlated with visual field MD and OCT measurements. Hierarchical clustering two distinct groups (NAION and control), where standardized measurements of NAION eyes were generally lower than controls. Two-way mixed ANOVAs showed significant interaction between patient status (control and chronic NAION) and structure (optic disk and macula) for annulus VAD and flux values and mean RNFL and GCC thickness. Post-hoc tests showed this effect stems from lower peripapillary values in NAION compared to controls. Separate logistic regression models with LASSO regularization identified VAD and flux are one of the best OCTA parameters for predicting NAION. CONCLUSION: Ischemic insult to the optic disk is more severe likely from primary degeneration of the affected peripapillary region while macula is affected by secondary retrograde degeneration and loss of retinal ganglion cells. In addition to OCT measurements, peripapillary and macular vascular parameters such as VAD and flux are good predictors of optic nerve and retinal changes in NAION.
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spelling pubmed-98774202023-01-27 Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy Pugazhendhi, Sangeethabalasri Yu, Miaomiao Zhou, Gabriella Chen, Yuxuan Wang, Ruikang Liao, Yaping Joyce Front Med (Lausanne) Medicine PURPOSE: The hallmark of non-arteritic anterior ischemic optic neuropathy (NAION) is vascular compromise to the anterior optic nerve and thinning of the retinal nerve fiber layer (RNFL) and secondary degeneration of the retinal ganglion cell body or thinning of the ganglion cell complex (GCC). This study investigates optical coherence tomography (OCT) and OCT Angiography (OCTA) changes in chronic NAION and identifies imaging biomarkers that best predict disease. METHODS: We performed a retrospective case-control study of 24 chronic NAION eyes (18 patients) and 70 control eyes (45 patients) to compare both whole-eye and regional OCT, OCTA, static perimetry measurements. OCT measurements were quantified automatically using commercial software, and OCTA was analyzed using custom MATLAB script with large vessel removal to measure 154 total parameters per eye. RESULTS: We confirmed that static perimetry mean deviation (MD) was significantly worse in chronic NAION (–13.53 ± 2.36) than control (–0.47 ± 0.72; P < 0.001) eyes, and NAION eyes had 31 μm thinner RNFL (control: 95.9 ± 25.8 μm; NAION: 64.5 ± 18.0, P < 0.001), and 21.8 μm thinner GCC compared with controls (control: 81.5 ± 4.4 μm; NAION: 59.7 ± 10.5, P < 0.001). Spearman correlation analysis of OCTA parameters reveal that vessel area density (VAD) and flux are highly correlated with visual field MD and OCT measurements. Hierarchical clustering two distinct groups (NAION and control), where standardized measurements of NAION eyes were generally lower than controls. Two-way mixed ANOVAs showed significant interaction between patient status (control and chronic NAION) and structure (optic disk and macula) for annulus VAD and flux values and mean RNFL and GCC thickness. Post-hoc tests showed this effect stems from lower peripapillary values in NAION compared to controls. Separate logistic regression models with LASSO regularization identified VAD and flux are one of the best OCTA parameters for predicting NAION. CONCLUSION: Ischemic insult to the optic disk is more severe likely from primary degeneration of the affected peripapillary region while macula is affected by secondary retrograde degeneration and loss of retinal ganglion cells. In addition to OCT measurements, peripapillary and macular vascular parameters such as VAD and flux are good predictors of optic nerve and retinal changes in NAION. Frontiers Media S.A. 2023-01-12 /pmc/articles/PMC9877420/ /pubmed/36714135 http://dx.doi.org/10.3389/fmed.2022.1033838 Text en Copyright © 2023 Pugazhendhi, Yu, Zhou, Chen, Wang and Liao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Pugazhendhi, Sangeethabalasri
Yu, Miaomiao
Zhou, Gabriella
Chen, Yuxuan
Wang, Ruikang
Liao, Yaping Joyce
Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
title Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
title_full Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
title_fullStr Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
title_full_unstemmed Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
title_short Peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
title_sort peripapillary and macular microvasculature features of non-arteritic anterior ischemic optic neuropathy
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877420/
https://www.ncbi.nlm.nih.gov/pubmed/36714135
http://dx.doi.org/10.3389/fmed.2022.1033838
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