Optical Coherence Tomography Angiography Assessment of the Peripapillary Vessel Density and Structure in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy: A Meta-Analysis.

Ling Ling,Qinglin Zhang,Yiqiao Xing,Wentian Zhou,Kaibao Ji,Liping Xie,Feifei Gao,Maurizio Battaglia Parodi

doi:10.1155/2020/1359120

Abstract

Background This meta-analysis is aimed at assessing the peripapillary vessel density (VD) and structural outcomes using optical coherence tomography angiography (OCTA) in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases for literature comparing VD and structural outcomes in patients with NAION and controls was performed. Mean differences (MDs) and its 95% confidence interval (CI) were calculated for continuous estimates. Review Manager (V5.30) was used for analysis. Results Fourteen published studies met the requirement. The radial peripapillary capillary (RPC) whole enface VD measured by OCTA was significantly lower in patients with NAION compared to that of the controls (MD = −10.51, P < 0.00001). The RPC inside disc VD was significantly decreased in the NAION group than that in the control group (MD = −8.47, P < 0.00001). For RPC peripapillary VD, there was a statistically significant difference between patients with NAION and the controls (MD = −12.48, P < 0.00001). The peripapillary retinal nerve fibre layer (p-RNFL) thickness was significantly lower in patients with NAION in comparison to the controls (MD = −22.18, P = 0.004). The ganglion cell complex (GCC) thickness in the macular zone of NAION patients was remarkably reduced compared to that in the controls (MD = −17.18, P = 0.0002). Conclusions The findings suggested that the peripapillary VD and RNFL thickness were attenuated, and the macular GCC thickness was reduced in patients with NAION. OCTA, in the future, may facilitate the diagnosis and monitoring of patients with NAION.

Highlights

Nonarteritic anterior ischemic optic neuropathy (NAION) is a visually threatening optic neuropathy characterised by sudden and rapidly painless vision loss, altitudinal visual field defect, and optic disc oedema [1]
The underlying mechanism of nonarteritic anterior ischemic optic neuropathy (NAION) remains unknown, the available evidence reveals that it may be associated with perfusion deficiency of the optic nerve head (ONH) microcirculation that is predominantly supplied by the short posterior ciliary arteries [4,5,6]
The pooled mean difference (MD) for radial peripapillary capillary (RPC) whole enface vessel density (VD) between the NAION and control groups was -10.51, with significant heterogeneity across studies, showing that the RPC whole enface VD was lower in the NAION group

Summary

Introduction

Nonarteritic anterior ischemic optic neuropathy (NAION) is a visually threatening optic neuropathy characterised by sudden and rapidly painless vision loss, altitudinal visual field defect, and optic disc oedema [1]. BioMed Research International [11] Among these imaging techniques, fundus fluorescein angiography (FFA) is currently the standard procedure to recognize the impaired ONH blood flow in NAION [12]. Several studies conducted by OCTA have demonstrated decreased vessel densities in the ONH and radial peripapillary capillary (RPC) in the eyes with NAION [16,17,18]. To our knowledge, there has been no meta-analysis comprehensively investigating the peripapillary vessel density and structural features related to patients with NAION. The radial peripapillary capillary (RPC) whole enface VD measured by OCTA was significantly lower in patients with NAION compared to that of the controls (MD = −10:51, P < 0:00001). The peripapillary retinal nerve fibre layer (p-RNFL) thickness was significantly lower in patients with NAION in comparison to the controls (MD = −22:18, P = 0:004). OCTA, in the future, may facilitate the diagnosis and monitoring of patients with NAION

Methods

Results

Conclusion