■乳头周围脉络膜与视神经共享血液供应,并直接与视神经并列,因此可能与非动脉炎性前部缺血性视神经病变(NAION)的发病机制有关。先前评估乳头状脉络膜厚度(PCT)或脉络膜血管指数(CVI;灌注面积与总脉络膜面积之比)的研究产生了混合的结果。没有人研究PCT和CVI之间的关系或证明功能相关。我们假设,在出现NAION的患者中,较高的PCT和较低的CVI与视觉功能相关。
■17只眼NAION(9只急性,13例患者中有8例非急性)和6例未受影响的“同伴”眼,在2017-2018年间,18名年龄匹配的对照受试者的18只眼使用扫频源光学相干断层扫描(SS-OCT)进行了前瞻性成像.比较各组间的平均PCT和CVI测量值以及在同一访视时的相应自动测量性能。
■方差分析显示PCT明显更大(NAION:278±65μm,Fellow:221±50μm,对照:158±27μm,与对照组相比,NAION患者的p<0.001)和CVI较低(NAION:0.35±0.03,研究员:0.35±0.04,对照:0.38±0.02,p<0.005)。Bonferroni校正的成对比较显示,与对照眼相比,NAION感染眼的PCT更高,CVI更低(p值<0.008),NAION和其他眼之间的PCT或CVI没有显着差异(p值>0.06)。在未受影响的其他眼睛中,PCT与CVI呈负相关(r=-0.8,p<0.05),但不在急性NAION眼中(r=-0.1,p>0.7),非急性NAION眼(r=0.1,p>0.7),或对照(r=-0.3,p>0.2)。鼻CVI与非急性NAION的平均偏差评分呈正相关(r=0.8,p<0.02),但在其他未受影响的眼睛(r=0.8,p>0.05)或严重受影响的NAION眼睛(r=-0.3,p>0.4)中没有。平均和时间PCT与未受影响的眼睛之间的模式标准偏差分数相关(r=0.8,p<0.04;r=0.9,p<0.03),但不包括急性NAION眼(r=-0.2,p>0.5;r=-0.1,p>0.7)或非急性NAION眼(r=0.1,p>0.7;r=0.05,p>0.9)。
■NAION和未受影响的眼睛显示脉络膜厚度增加和血管密度降低。在NAION的非急性受影响的眼睛中,视野表现与血管密度直接相关。正在进行的工作将为这些结构-功能关系与致病性和病理生理相关性提供进一步的见解。
UNASSIGNED: The peripapillary choroid shares a blood supply with and is directly apposed to the optic nerve, and therefore may contribute to the pathogenesis of non-arteritic anterior ischemic optic neuropathy (NAION). Prior studies evaluating peripapillary choroidal thickness (PCT) or choroidal vascularity index (CVI; the ratio of the perfused area to total choroid area) have produced mixed results. None investigated the relationship between PCT and CVI or demonstrated functional correlates. We hypothesized that greater PCT and lower CVI would correlate with visual function in patients presenting with NAION.
UNASSIGNED: Seventeen eyes with NAION (9 acute, 8 non-acute) and 6 unaffected \"fellow\" eyes in 13 patients, and 18 eyes in 18 age-matched control subjects were imaged using swept-source optical coherence tomography (SS-OCT) prospectively between 2017-2018. Mean PCT and CVI measurements were compared across groups and with respect to corresponding automated perimetric performance at the same visit.
UNASSIGNED: Analysis of variance showed significantly greater PCT (NAION: 278 ± 65 μm, Fellow: 221 ± 50 μm, Control: 158 ± 27 μm, p<0.001) and lower CVI (NAION: 0.35 ± 0.03, Fellow: 0.35 ± 0.04, Control: 0.38 ± 0.02, p<0.005) in patients with NAION compared to control subjects. Bonferroni-corrected pairwise comparisons showed greater PCT and lower CVI in NAION-affected eyes compared to control eyes (p values<0.008), and no significant differences in PCT or CVI between NAION and fellow eyes (p values>0.06). PCT was negatively correlated with CVI among unaffected fellow eyes (r=-0.8, p<0.05), but not among acute NAION eyes (r=-0.1, p>0.7), non-acute NAION eyes (r=0.1, p>0.7), or controls (r=-0.3, p>0.2). Nasal CVI was positively correlated with mean deviation scores in non-acute NAION (r=0.8, p<0.02), but not among fellow unaffected eyes (r=0.8, p>0.05) or acutely affected NAION eyes (r=-0.3, p>0.4). Mean and temporal PCT correlated with pattern standard deviation scores among unaffected fellow eyes (r=0.8, p<0.04; r=0.9, p<0.03), but not among acute NAION eyes (r=-0.2, p>0.5; r=-0.1, p>0.7) or non-acute NAION eyes (r=0.1, p>0.7; r=0.05, p>0.9).
UNASSIGNED: NAION and unaffected fellow eyes demonstrate increased choroidal thicknesses and reduced vascular density. Perimetric performance is directly associated with vascular density among non-acutely affected eyes with NAION. Ongoing work will provide further insights into these structure-function relationships with pathogenic and pathophysiologic relevance.