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  • Peripapillary and parafoveal vascular network assessment by optical coherence tomography angiography in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders

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Clinical science
Peripapillary and parafoveal vascular network assessment by optical coherence tomography angiography in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders
  1. Yongheng Huang1,
  2. Lei Zhou2,
  3. Jingzi ZhangBao2,
  4. Tongjia Cai3,
  5. Bei Wang3,
  6. Xiaoyang Li2,
  7. Liang Wang2,
  8. Chuanzhen Lu2,
  9. Chongbo Zhao2,
  10. Jiahong Lu2,
  11. Chao Quan2,
  12. Min Wang1
  1. 1Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  2. 2Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  3. 3Department of Neurology, Jing’an District Centre Hospital of Shanghai, Shanghai, China
  1. Correspondence to Dr Chao Quan, Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China; chao_quan{at}fudan.edu.cn; Dr Min Wang, Department of Ophthalmology, Eye and ENT hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China; wangmin83{at}yahoo.com

Abstract

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
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bjophthalmol-2018-312231

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    Footnotes

    • 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.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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