Peripapillary Changes Research Articles

IDIOPATHIC MULTIFOCAL CHOROIDITIS WITH SERPIGINOUS-LIKE PERIPAPILLARY CHORIORETINAL ATROPHY.

To report nine cases of multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy. A retrospective observational case series of eyes with multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy. Multimodal imaging findings were reviewed and presented. Fifteen eyes of 9 patients (6 women and 3 men), with a mean age of 48.1 years (median, 46 years; range, 23-74 years), presented with multifocal choroiditis serpiginous-like peripapillary chorioretinal atrophy. All 15 eyes presented with serpiginoid peripapillary changes and had discrete patches of atrophy or punched-out scars in the posterior pole or periphery. Eleven eyes (73.3%) had cone-shaped retinal pigment epithelium elevations on optical coherence tomography, 10 eyes (66.7%) had mild vitritis, and 4 eyes (26.7%) had peripheral curvilinear streak lesions. Three eyes (20%) had choroidal neovascularization. All patients responded well to treatment with systemic immunosuppression, local corticosteroid injections, and/or intravitreal anti-vascular endothelial growth factor injections. Multifocal choroiditis may present with peripapillary chorioretinal changes resembling a serpiginous-like choroiditis in addition to the classic findings of patches of atrophy or punched-out scars in the posterior pole or periphery, cone-shaped retinal pigment epithelium elevated on optical coherence tomography and peripheral curvilinear streak lesions.

Intracranial pressure and optic disc changes in a rat model of obstructive hydrocephalus

BackgroundThe kaolin induced obstructive hydrocephalus (OHC) model is well known for its ability to increase intracranial pressure (ICP) in experimental animals. Papilledema (PE) which is a predominant hallmark of elevated ICP in the clinic has not yet been studied in this model using high-resolution digital fundus microscopy. Further, the long-term effect on ICP and optic nerve head changes have not been fully demonstrated. In this study we aimed to monitor epidural ICP after induction of OHC and to examine changes in the optic disc. In addition, we validated epidural ICP to intraventricular ICP in this disease model.MethodThirteen male Sprague-Dawley rats received an injection into the cisterna magna containing either kaolin-Ringer’s lactate suspension (n = 8) or an equal amount of Ringer’s lactate solution (n = 5). Epidural ICP was recorded post-operatively, and then continuously overnight and followed up after 1 week. The final epidural ICP value after 1 week was confirmed with simultaneous ventricular ICP measurement. Optic disc photos (ODP) were obtained preoperatively at baseline and after one week and were assessed for papilledema.ResultsAll animals injected with kaolin developed OHC and had significant higher epidural ICP (15.49 ± 2.47 mmHg) compared to control animals (5.81 ± 1.33 mmHg) on day 1 (p < 0.0001). After 1 week, the epidural ICP values were subsided to normal range in hydrocephalus animals and there was no significant difference in epidural ICP between the groups. Epidural ICP after 1 week correlated with the ventricular ICP with a Pearson’s r = 0.89 (p < 0.0001). ODPs from both groups showed no signs of acute papilledema, but 5 out of 8 (62.5%) of the hydrocephalus animals were identified with peripapillary changes.ConclusionsWe demonstrated that the raised ICP at day 1 in the hydrocephalus animals was completely normalized within 1 week and that epidural ICP measurements are valid method in this model. No acute papilledema was identified in the hydrocephalus animals, but the peripapillary changes indicate a potential gliosis formation or an early state of a growing papilledema in the context of lateral ventricle dilation and increased ICP.

Peripapillary Vascular Density Measurement in Pediatric Renal and Liver Transplant.

Noninvasive monitorization of retinal structures of the eye could be a predictor for systemic microvasculature dysfunction in transplant recipients. In this study, our purpose was to determine the optic disc and peripapillary microvascular changes in pediatric patients who had undergone liver or renal transplant surgery. The study was performed at Başkent University. The medical records were reviewed, and patients who had liver or renal transplant in the last 10 years and were between 4 and 18 years old were included in the study. The optic disc and peripapillary vascular density parameters were obtained by optical coherence tomography angiography (Avanti RTVue XR). The results were compared with the results from age-matched, sex-matched, and spherical equivalent-matched healthy subjects. Our study included 32 eyes of 16 liver transplant patients, 20 eyes of 10 renal transplant patients, and 64 eyes of 32 healthy participants (control). Whole image peripapillary, inside disc, peripapillary, superior and inferior hemisphere, and superior, inferior, temporal, and nasal quadrant peripapillary vascular densities were evaluated. No statistically significant differences in any parameter were noted between the healthy control group and the patient groups (P > .05 for all parameters). Peripapillary vascular density measurements were not affected in pediatric renal and liver transplant patients.

Parafoveal and peripapillary vessel density in pediatric and juvenile craniopharyngioma patients

We assessed the retinal microvascular alterations detected by optical coherence tomography angiography (OCT-A) in pediatric and juvenile craniopharyngioma (CP) patients with chiasmal compression. We included 15 eyes of 15 pediatric or juvenile CP patients and 18 eyes of 18 healthy subjects. The evaluation of vessel density from the superficial retinal capillary plexus (SRCP), the deep retinal capillary plexus, and the radial peripapillary capillary (RPC) segments was obtained by OCT-A. The association between vessel density measures and functional and structural measurements was also analyzed. There were significant reductions in the nasal sector of the SRCP (p < 0.0001) and all sectors of the RPC segment vessel density (nasal, temporal, and superior; p < 0.0001, inferior; p = 0.0015) in CP patients postoperatively compared to the healthy subjects. The peripapillary retinal nerve fiber layer (r = 0.6602, p = 0.0074) and ganglion cell-inner plexiform layer thicknesses (r = 0.7532, p = 0.0030) were associated with RPC segment vessel density. Visual acuity (r = − 0.5517, p = 0.0330) and temporal visual field sensitivity loss (r = 0.5394, p = 0.0465) showed an association with SRCP vessel density. In pediatric and juvenile patients with CP, parafoveal and peripapillary vascular changes following chiasmal compression were observed. The changes in vascular structures were closely related to structural and functional outcomes.

A Pilot Study of Subclinical Non-Capillary Peripapillary Perfusion Changes in Thyroid-Related Orbitopathy Detected Using Optical Coherence Tomography Angiography.

PurposeHemodynamic changes surrounding the optic nerve head are known to occur in thyroid-related orbitopathy (TRO). This pilot study explores the capillary and non-capillary peripapillary perfusion changes of the retina in TRO eyes without dysthyroid optic neuropathy (DON) using optical coherence tomography angiography (OCT-A).MethodsNon-capillary and capillary peripapillary perfusion densities were calculated using single 4.5 × 4.5mm en face “RPC layer” OCT-A scans of 8 TRO patients without DON (8 eyes, mean age 40.6 years, range 23–69 years). Results were compared to a previously published dataset of 133 healthy controls (133 eyes, mean 41.5 years, range 11–83 years). The strength of association was measured between OCT-A perfusion densities and clinical measures of TRO.ResultsNon-capillary peripapillary perfusion density in TRO eyes was found to be significantly decreased compared to healthy controls (TRO group 15.4 ± 2.9% vs controls 21.5 ± 3.1%; p < 0.0001). Capillary peripapillary perfusion densities showed no significant difference (TRO group 42.5 ± 1.8% vs controls 42.5 ± 1.5%; p = 1.0). Clinical measures of disease did not correlate well with OCT-A perfusion densities (p>0.05).ConclusionThese findings may represent decreased blood flow and subclinical ischemia to the optic nerve. We discuss possible pathogenic mechanisms of thyroid-related vasculopathy, including vessel wall thickening due to immunologically-induced media enlargement.

The current clinical role of optical coherence tomography angiography in neuro-ophthalmological diseases.

After the revolutionary effect of optical coherence tomography (OCT) on ophthalmology practice, recent OCT-based technology OCT angiography (OCT-A) also has rapidly gained a wide clinical acceptance. OCT-A is a noninvasive, depth-resolved imaging tool for the evaluation of retinal vascular changes. Since its introduction, the understanding of retinal vascular diseases, pacychoroid spectrum diseases, and other diseases have been enriched in many ways. More importantly, OCT-A provides depth-resolved information that has never before been available. The whole spectrum of neuro-ophthalmological diseases shows consistent peripapillary and macular capillary changes with structural and functional correlation. The superficial and deeper retinal and choroidal vasculatures are affected depending on the nature of the disease process. Therefore, OCT-A play an important role in the diagnosis and management of optic nerve-related diseases as well. In this review, we summarized existing literature on the use of OCT-A in neuro-ophthalmological diseases such as arteritic anterior ischemic neuropathy, nonarteritic anterior ischemic neuropathy, papillitis, papilledema, multiple sclerosis. Currently, OCT-A has an important position as a useful, noninvasive tool in the evaluation of neuro-ophthalmologic diseases; however, OCT-A has several limitations regarding its technical capabilities in challenging neuro-ophthalmic cases. With the improvement in the technical capacity of OCT-A, it will have a more important place in the diagnosis and follow-up of neuro-ophthalmological diseases in future.

Peripapillary changes after vitrectomy and silicone oil tamponade for rhegmatogenous retinal detachment.

Purpose:To evaluate the peripapillary changes after vitrectomy and silicone oil (SO) tamponade in eyes with rhegmatogenous retinal detachment (RRD).Methods:In this study, 25-gauge vitrectomy with SO tamponade was performed in 22 eyes with RRD. The radial peripapillary capillary (RPC) vessel density (VD) and retinal nerve fiber layer thickness (RNFLT) were assessed by optical coherence tomography angiography at 2, 4, 8, and 12 weeks postoperatively. The values of healthy fellow eyes were used as controls.Results:The global RPC VDs were significantly lower in the eyes with RRD than in fellow healthy eyes at 2 weeks (P < 0.001), and increased at 4 weeks, then decreased over time after surgery (F = 1.046, P = 0.377). The RPC VDs in the superior-hemifield were lower than those in the inferior-hemifield at 12 weeks postoperatively (t = −2.844, P = 0.010). The global RNFLTs decreased gradually after vitrectomy in the eyes with RRD (F = 1.312, P = 0.276). The RNFLTs in the superior-hemifield were thinner than those in the inferior-hemifield at 12 weeks postoperatively (t = −2.222, P = 0.037). The global, superior, and inferior RNFLTs were correlated with corresponding RPC VDs in the eyes with RRD at all time-points postoperatively (P < 0.05).Conclusion:RRD resulted in the decrease of RPC VDs. The RPC VDs recovered in the early postoperative period but were still lower than the normal level. Long-term application of SO tamponade resulted in the reduction of peripapillary VDs secondary to loss of RNFLTs.

Correlation between the optic nerve pial diameter and radial peripapillary vascular changes in primary open-angle glaucoma

PurposeTo assess the optic nerve pial diameter (ONPD) in patients with primary open-angle glaucoma (POAG) using standardized A-scan ultrasound and to evaluate the correlation between the ONPD and structural, vascular optic nerve head features and visual field parameters in glaucomatous eyes.MethodsIn this prospective study, we enrolled 126 eyes of 63 POAG patients and 124 eyes of 62 healthy controls. In all subjects, the ONPD was evaluated by means of A-scan ultrasound. Spectral domain (SD)-OCT was used to assess ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), thicknesses, and the optic nerve head (ONH) morphology. OCTA measured the vessel density (VD) of radial peripapillary capillary (RPC) plexus.ResultsThe ONPD showed a statistically significant reduction in POAG group with respect to controls (p < 0.001). SD-OCT and OCTA parameters showed a significant impairment in patient group with respect to controls (p < 0.001). The ONH analysis revealed significantly lower values in rim area (p = 0.009) and an increased cup-to-disc area ratio (p = 0.013) and cup volume (p < 0.001) in patients with respect to controls. Significant correlations were shown in POAG group between ONPD and RPC plexus (p = 0.006). Moreover, significant correlation was also found between ONPD and structural SD-OCT parameters (p = 0.001) and between ONPD and visual field parameters (p = 0.001).ConclusionsThe standardized A-scan ultrasound measurements of the ONPD showed a significant correlation with structural and vascular glaucomatous changes measured by means of SD-OCT and OCTA. These results confirm the diagnostic reliability of the ultrasound evaluation in glaucoma optic neuropathy.

Quantification of vascular and neuronal changes in the peripapillary retinal area secondary to diabetic retinopathy

PurposeTo investigate and quantify peripapillary vascular and neuronal changes secondary to diabetic retinopathy, using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA).DesignThis was a cross-sectional study.Methods51 eyes of 51...

Evaluation of early retinal vascular changes by optical coherence tomography angiography in children with type 1 diabetes mellitus without diabetic retinopathy.

To evaluate macular and peripapillary vascular changes by optical coherence tomography angiography (OCTA) in children with type 1 diabetes mellitus (T1DM) without diabetic retinopathy (DR). This study included 46 patients with T1DM and 46 age-sex matched healthy subjects. All participants were evaluated in terms of macular and optic disk parameters by using AngioVue. Foveal avascular zone (FAZ) area, macular and optic disk vessel density (VD) were analyzed. The correlation of these parameters with metabolic factors such as disease duration, mean hemoglobin A1c (HbA1c), insulin-like growth factor 1 (IGF-1) standard deviation score (SDS), homocysteine (Hcy) level, body mass index (BMI) SDS and daily insulin dose was also investigated in T1DM group. No significant difference was found in FAZ area and optic disk radial peripapillary capillary (RPC) VD comparing diabetic and control groups. In all macular regions, VD was significantly lower in T1DM versus control group both in superficial capillary plexus (SCP) and deep capillary plexus (DCP). None of the metabolic parameters was correlated with FAZ area and optic disk RPC-VD. Vascular density in SCP was negatively correlated with mean HbA1c and positively correlated with IGF-1 SDS. Homocysteine level was negatively correlated with DCP-VD in all areas. In children with T1DM without clinically apparent DR, VD in SCP and DCP was decreased and OCTA is a valuable imaging technique for detecting early vascular changes. The metabolic parameters such as mean HbA1c, IGF-1 SDS and Hcy affect the macular VD in diabetic children. 2011-KAEK-2, 2021/4, Trial registration date: 02.04.2021.

Acute and subacute macular and peripapillary angiographic changes in choroidal and retinal blood flow post-intravitreal injections

Whether post injectional acute intraocular pressure (IOP) increase is associated with decreased peripapillary and macular perfusion is still under debate. Here, we investigated early changes in the choroidal and retinal blood flow using OCTA imaging in a cohort of patients undergoing anti-VEGF intravitreal injections (IVI) for macular edema following retinal vein occlusion and diabetic retinopathy. In this prospective single-center, observational study, the pre- and post-IVI changes in retinal perfusion were examined via assessment of vessel length density (VLD) and vessel density (VD) in deep and superficial capillary segmentations (DCP and SCP), foveal avascular zone (FAZ) in SCP, as well as flow signal deficits in the choriocapillaris segmentation. Mean IOP significantly changed over the study course (p = 0.000; ANOVA). Measurements at 5 min post-IVI (33.48 ± 10.84 mmHg) differed significantly from baseline (17.26 ± 2.41 mmHg, p = 0.000), while measurements from one day, one week, and one-month post-IVI did not (p = 0.907, p = 1.000 and p = 1.000 respectively). In comparison to baseline, no changes in OCTA parameters, including FAZ, VD, VLD, and FV, were detected 5 min post-IVI. No significant alterations in OCTA parameters were observed during study course. Increased IOP spikes were detected post-IVI; however, no potential permanent ischemic retinal damage was suspected.

Особливості перипапілярних нейрональних змін у хворих з аксіальною діабетичною оптичною нейропатією залежно від стадії захворювання

Мета роботи: проаналізувати особливості змін перипапілярних нервових волокон сітківки у хворих з аксіальною діабетичною оптичною нейропатією (ДОН) залежно від стадії захворювання. Матеріали та методи. Аналіз особливостей змін перипапілярних нервових волокон сітківки виконано на підставі даних обстеження 280 хворих (460 очей) з аксіальною ДОН віком 55,9 ± 7,8 року. Субклінічна стадія ДОН спостерігалась у 50,2 % очей (231 око) хворих з аксіальною ДОН, початкова стадія — у 20,7 % очей (95 очей), виражена стадія — у 19,8 % очей (91 око), дистрофічна стадія — у 9,3 % очей (43 ока). Контрольну групу становили 50 здорових осіб (100 очей). Крім стандартних, методи офтальмологічного дослідження включали оптичну когерентну томографію сітківки та зорового нерва. Аналі­зували середню товщину шару перипапілярних нервових волокон і товщину цього шару у верхній і нижній половині. Результати. В результаті проведених досліджень у хворих з аксіальною діабетичною оптичною нейропатією було виявлено, що товщина шару перипапілярних нервових волокон сітківки при вираженій стадії аксіальної ДОН на 38,7 % перевищує, а при субклінічній, початковій та дистрофічній стадіях аксіальної ДОН на 8,0, 13,8, 20,5 % відповідно є меншою показника здорових осіб. Відмічено помірне потовщення перипапілярних нервових волокон сітківки у хворих із вираженою стадією аксіальної ДОН, помірне витончення перипапілярних нервових волокон сітківки відмічається при субклінічній стадії аксіальної ДОН, виражене витончення — при початковій та дистрофічній стадіях аксіальної ДОН. Висновки. З отриманих результатів встановлено, що особливості перипапілярних нейрональних змін залежать від стадії аксіальної діабетичної нейропатії.

Peripapillary Halo in Inflammatory Papillitis of Birdshot Chorioretinopathy.

PurposePeripapillary halos (PPH) are peripapillary changes observed surrounding the optic nerve head in normal eyes and eyes with different disorders. Recognizing the microstructure and mechanism of development of these halos will help clinicians understand the different associated retinal and optic nerve head pathologies. We describe the in vivo histological characteristics of PPH in birdshot chorioretinopathy (BSCR).Patients and MethodsThis was a prospective observational case-series in a single tertiary referral center. Six eyes of three patients with PPH associated with BSCR were determined through clinical examination, fundus photography, and fundus autofluorescence (FAF). Patients underwent swept-source optical coherence tomography (SS-OCT) imaging of the optic nerve head and peripapillary region.ResultsIn SS-OCT B-scans across the area of PPH, we observed thinning and interruption of retinal pigment epithelium (RPE)-Bruch’s membrane complex. These halos are a circumferential form of alpha zone RPE-associated crescentic peripapillary atrophy (PPA), unlike the PPH observed with myopia and normal aging.ConclusionPPH in BSCR patients may be a sign of prior inflammatory optic neuropathy.

Optic disc morphology and peripapillary atrophic changes in diabetic children and adults without diabetic retinopathy or visual impairment.

PurposeTo investigate the changes in optic disc morphology and peripapillary atrophy (PPA) in diabetic children and adults without diabetic retinopathy (DR) or visual impairment (VI).MethodsThis cross‐sectional study included two groups of subjects. One group included 91 children with type 1 diabetes mellitus (T1DM) and 86 healthy children, and the other group included 444 adults with T2DM and 442 healthy controls. The optic disc parameters including major and minor axis lengths, optic disc ovality (ODO), optic disc tilt, optic disc area and β‐PPA area were analysed in all subjects. Optic disc rotation and the Bergmeister papilla were analysed only in children. Patients with diabetes and healthy controls were compared in each group of the study population.ResultsIn both groups, patients with diabetes and healthy controls were matched for age, sex and axial length (AL). Among the children, β‐PPA area was significantly smaller in those with diabetes (0.29 ± 0.43 mm2) than in the healthy controls (0.46 ± 0.58 mm2, p < 0.05). Multiple linear regression analysis showed that diagnosis of DM was negatively associated with β‐PPA area. Longer AL and higher body mass index (BMI) were positively associated with β‐PPA area. Among adults, ODO was significantly larger in those with diabetes (1.14 ± 0.09) than in healthy controls (1.12 ± 0.06, p < 0.05). Multiple linear regression analysis showed that the BMI and DM were potential risk factors affecting ODO.ConclusionHyperglycaemia had different effects on the optic disc in children and adults. Unlike in healthy controls, hyperglycaemia had an impact on the peripapillary tissue in children and on optic disc shape in adults before DR and VI development.

Optic Disc Features in Familial Retinal Arteriolar Tortuosity.

Describing optic disc appearance in familial retinal arteriolar tortuosity (fRAT) using multimodal imaging and raising awareness of peripapillary arterial changes due to this disorder. A cross-sectional study was performed in four consecutive patients of two non-related families. Detailed ophthalmological examination was performed and supported by medical and family history and multimodal imaging. In all subjects, increased tortuosity of second- and third-order retinal arteries in superior and deeper vascular plexus was documented. Furthermore, tortuosity in the peripapillary circle of Zinn-Haller was found. In addition, retinal vessel oximetry confirmed tortuosity only of the arterial vessels. The present data suggests that a blurry bordered, hyperemic optic disc in the presence of abnormally tortuous arteriolar vessels and asymptomatically or oligosymptomatically spontaneously resolved hemorrhages could be associated with a fRAT. This finding could be linked to peripapillary arterial vessel tortuosity.

Peripapillary vascular density and retinal nerve fibre layer changes in patients with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a systemic disease which may cause end organ damage. In this study, we aimed to investigate the radial peripapillary capillary (RPC) density and retinal nerve fibre layer (RNFL) thickness changes in patients with COPD. The right eyes of 35 patients with COPD and 35 healthy controls were evaluated with optical coherence tomography angiography (OCTA). RPC density values and RNFL thicknesses were measured and compared. The mean inside disc vascular density and the mean peripapillary vascular density values were lower in the COPD group (p=0.002, p<0.001, respectively). When the peripapillary area was evaluated independently as eight different quadrants, the RPC density values were lower in the COPD group in all of the quadrants except superotemporal and temporal superior quadrants. RNFL was thinner in all quadrants in the COPD group compared to the control group. But this difference was significant only in the nasal superior and inferonasal quadrants (p=0.03, p=0.04, respectively). Although, there was no correlation between the mean RPC density and the mean peripapillary RNFL thickness of the patients, FEV1 values for all patients were found to be correlated with the mean peripapillary RPC density (r=0.406, p=0.015). OCTA may have a potential to be used in the follow-up of COPD patients.

Choroidal and peripapillary changes in high myopic eyes with Stickler syndrome

BackgroundTo compare different clinical and Spectral-Domain Optical Coherence Tomography (SD-OCT) features of high myopic eyes with Stickler syndrome (STL) with matched controls.MethodsPatients with genetically confirmed STL with axial length ≥ 26 mm and controls matched for axial length were included. The following data were obtained from SD-OCT scans and fundus photography: choroidal and retinal thickness (respectively, CT and RT), peripapillary atrophy area (PAA), presence of posterior staphyloma (PS).ResultsTwenty-six eyes of 17 patients with STL and 25 eyes of 19 controls were evaluated. Compared with controls, patients with STL showed a greater CT subfoveally, at 1000 μm from the fovea at both nasal and temporal location, and at 2000 and 3000 μm from the fovea in nasal location (respectively, 188.7±72.8 vs 126.0±88.7 μm, 172.5±77.7 vs 119.3±80.6 μm, 190.1±71.9 vs 134.9±79.7 μm, 141.3±56.0 vs 98.1±68.5 μm, and 110.9±51.0 vs 67.6±50.7 μm, always P< 0.05). Furthermore, patients with STL showed a lower prevalence of PS (11.5% vs 68%, P< 0.001) and a lower PAA (2.2±2.1 vs 5.4±5.8 mm2, P=0.03), compared with controls.ConclusionsThis study shows that high myopic patients with STL show a greater CT, a lower PAA and a lower prevalence of PS, compared with controls matched for axial length. These findings could be relevant for the development and progression of myopic maculopathy in patients with STL.

Evaluation of Peripapillary and Macular Vascular Flow Changes with OCT-A in Patients with Superficial Optic Disk Drusen.

ObjectivesThe purpose of this study was to compare the peripapillary and macular vascular flow changes between healthy adults and adult patients with superficial optic disk drusen (ODD), as evaluated by optical coherence tomography angiography (OCT-A).MethodsIn this retrospective study, 44 eyes of 22 patients with superficial ODD followed-up in our neuro-ophthalmology unit and 54 eyes of 27 healthy individuals admitted to our clinic for routine ophthalmological examination were included in the study. The superior, inferior, nasal, and temporal radial peripapillary capillary plexus (RPC) vessel density (VD) values; superior, inferior, nasal, and temporal parafoveal and foveal region superficial capillary plexus (SCP) and deep capillary plexus (DCP) VD values; and choriocapillaris flow (CCF) area and foveal avascular zone area were evaluated by OCT-A.ResultsThere was no statistically significant difference between groups in terms of age and sex. While there was a significant decrease in the temporal RPC VD values in cases with ODD (p=0.02), no significant difference was observed in other quadrants. No significant differences in either parafoveal zone four quadrant, foveal SCP and DCP VD values, or foveal avascular zone measurements were found between groups, while CCF area values were significantly higher in the study group (p=0.012).ConclusionCompared to healthy controls, our results showed a decrease in the RPC temporal quadrant VD values, and an increase in CCF area in cases with superficial ODD. To evaluate the effects of ODD on optic nerve head and macular perfusion, and to understand its underlying mechanisms and secondary complications, longer follow-up studies with larger case series are needed.

Relationship between peripapillary perfusion density, peripapillary flow index and traditional glaucoma measurements in open‐angle glaucoma and ocular hypertension: an optical coherence tomography angiography study

PurposeThis study aims to detect peripapillary vascular changes in patients with glaucoma and ocular hypertension compared to healthy eyes, and to correlate these vascular parameters with structural and functional parameters.Methods46 open‐angle glaucoma eyes (GE), 35 ocular hypertension eyes (OHE) and 47 age‐matched control eyes (CE) were analyzed. Visual field test was performed with the Humphrey Field Analyzer 3. Optic disc region was imaged using a 4.5 × 4.5 mm scan by a HD‐OCT Cirrus. Peripapillary perfusion density (PPD) and peripapillary flow index (PFI) were quantified by the owner’s algorithm. The statistical analysis was performed using the Kruskal‐Wallis Test with Bonferroni Post Hoc analysis and Spearman rank correlation.ResultsGE showed an attenuated PPD globally and in each sector compared to OHE and CE (−10.62%), being the superior and inferior sectors the most affected ones. PFI in GE was also lower than those in OHE and CE (−14.43%). PPD and PFI were also lower in OHE than those in CE (p &lt; 0.001 for all pairwise comparisons). Univariate regression analysis showed that PFI was correlated with retinal nerve fiber layer (RNFL) (r = +0.607) and visual field mean deviation (VFMD) (r = +0.586). PPD had a higher correlation with RNFL (r = +0.686) and VFMD (r = +0.609). Superior and inferior sectors were the most correlated (p &lt; 0.001 for all).ConclusionsVascular changes that occur in GE can be visualized as reduced PPD and, specially, as PFI. This finding was not previously described, and suggests that the structural damage may be caused to a greater extent by a decreased PFI more than by an attenuation of PPD. Furthermore, OHE also exhibited vascular abnormalities compared with CE. This indicates that vascular changes may occur before changes in retinal thickness at the early stages of glaucoma. All of these measures resulted to be positively correlated with traditional glaucoma parameters. So, quantitative OCTA may have value in the future to evaluate or follow up glaucoma and ocular hypertension patients.

Preclinical ocular features in patients with Behçet's disease detected by optical coherence tomography angiography.

The aim of this study was to evaluate the perifoveal and peripapillary microvascular structure in patients with Behçet's disease (BD) without clinically ocular involvement. Fifty-six eyes of 28 patients with Behçet's disease without clinically ocular involvement and 50 age-matched healthy eyes were included in this prospective study. Vessel densities (VD) of macula and optic nerve head, foveal avascular zone (FAZ), choroid capillary plexus (CCP) flow area, perifoveal capillary nonperfusion, capillary dilatation and/or telangiectasia and perifoveal capillary arcade disruption were analyzed with optical coherence tomography angiography (OCTA). The relationship between duration of disease and vessel densities was also evaluated. The FAZ was significantly higher in the BD group (p < 0.001). VD of the foveal and parafoveal region in deep capillary plexus (DCP) were significantly lower in the BD group than in the control group (p < 0.001, p < 0.001). Total disc, peripapillary and inside-disc VD were significantly lower in BD group (p = 0.001, p = 0.002, p = 0.004). Perifoveal morphological changes in DCP were significantly higher in nonocular BD (p < 0.001, p < 0.001, p < 0.001). There was a mild negative correlation between disease duration and whole VD in DCP, total disc VD, peripapillary VD was determined (For whole VD in DCP, r = -0.400, p = 0.035; for total disc VD r = -0.396, p = 0.037; for peripapillary VD r = -0.442, p = 0.018). Perifoveal and peripapillary microvascular changes that can be detected by OCTA may occur in Behçet's patients without clinically ocular involvement.