目的:描述非动脉炎性前部缺血性视神经(NAION)神经病的光学相干断层扫描血管成像(OCT-A)中视网膜乳头周围微血管的变化。
方法:对10例NAION急性期患者的观察性研究。OCT-A使用以视盘为中心的3mm×3mm正方形进行(CirrusHD-OCT,CarlZeissMeditec,都柏林,CA).对每位患者的健康眼睛进行了定性比较。所有患者均进行了荧光素血管造影(HRA2,海德堡,德国)和视野检查(章鱼101®,Haag-Streit,美国)。
结果:在受影响的眼睛中,OCT-A显示放射状乳头周围网络明显改变。在所有这些眼睛里,表面毛细血管放射状模式出现局灶性消失,扭曲和不规则。8只眼睛在一些重点地区也缺乏血管化,看起来像黑暗区域。在OCT-A上显示的血管改变的形貌与视野图案缺陷之间未发现相关性。
结论:OCT-A是一种新的成像技术,能够轻松安全地显示NAION急性期乳头周围毛细血管网络的变化。这些变化可能与NAION急性期前层视神经血流量减少有关。视野缺陷与OCT-A图像不相关,这表明它们可能主要是由于睫状后动脉血流的紊乱。
OBJECTIVE: To describe changes of the retinal peripapillary microvasculature on optical coherence tomography angiography (OCT-A) in non-arteritic anterior ischemic optic (NAION) neuropathy.
METHODS: Observational study of 10 patients at the acute phase of NAION. OCT-A was performed using a 3mm×3mm square centered on the optic disc (Cirrus HD-OCT with Angioplex, Carl Zeiss Meditec, Dublin, CA). A qualitative comparison was made with the healthy fellow eye of each patient. All patients had a fluorescein angiography (HRA2, Heidelberg, Germany) and a visual field examination (Octopus 101®, Haag-Streit, USA).
RESULTS: In the affected eyes, OCT-A showed clear modifications in the radial peripapillary network. In all these eyes, a focal disappearance of the superficial capillary radial pattern was present, twisted and irregular. In 8 eyes, there was also a lack of vascularization in some focal areas, appearing as dark areas. No correlation was found between the topography of the vascular alteration shown on OCT-A and visual field pattern defects.
CONCLUSIONS: OCT-A is a new imaging technology able to demonstrate easily and safely the changes in the peripapillary capillary network during the acute phase of NAION. These changes are likely related to a decrease of the prelaminar optic nerve blood flow during the acute phase of NAION. Visual field defects are not correlated with OCT-A images, suggesting that they may be due mainly to disturbances in posterior ciliary artery blood flow.