Background/aims Current understanding of the alterations in the retinal vascular network in neuromyelitis optica spectrum disorders (NMOSDs) is limited. We aim to assess the peripapillary and parafoveal vessel density in aquaporin-4 antibody-positive NMOSD patients by optical coherence tomography (OCT) angiography.
Methods A total of 55 aquaporin-4 antibody-positive NMOSD patients with or without a history of optic neuritis (ON) and 33 healthy controls underwent spectral domain OCT and OCT angiography. Clinical histories, Expanded Disability Status Scale score, visual functional system score (VFSS) and disease duration were collected.
Results Peripapillary and parafoveal vessel density was significantly decreased in NMOSD eyes with or without a history of ON. The decrease in retinal vessel density could occur before ON and retinal nerve fibre layer (RNFL) atrophy. Peripapillary vessel density correlated well with the spectral domain OCT measurements and VFSS in NMOSD eyes with a history of ON.
Conclusion Subclinical primary retinal vasculopathy may occur in NMOSD prior to ON and RNFL atrophy. Peripapillary vessel density might be a sensitive predictor of visual outcomes in NMOSD patients with ON.
- neuromyelitis optica spectrum disorders (NMOSD)
- optic neuritis (ON)
- optical coherence tomography angiography
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YH and LZ contributed equally.
Contributors YH: OCT data acquisition and analysis, draft of the manuscript and study design. LZ: data acquisition and analysis, revision of the manuscript and study concepts. JZ: data acquisition and analysis and literature research. TC, BW, XL and LW: clinical history acquisition and analysis. CL: study concept and supervision. CZ: study concept and design. JL: study concept and design and manuscript review. CQ: critical revision of the manuscript for important intellectual content, study concept and design and manuscript final version approval. MW: critical revision of the manuscript for important intellectual content, study concept and design and study supervision.
Funding This work was supported by the National Natural Science Foundation of China (NSFC) grant number 81771296 and the National Key Research and Development Program of China grant number 2016YFC0901504.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study was approved by the Medical Ethics Committee of Huashan Hospital and Eye & ENT Hospital of Fudan University.
Provenance and peer review Not commissioned; externally peer reviewed.
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