Optical coherence tomography angiography findings in acute non-arteritic anterior ischaemic optic neuropathy

Author: Slim Salmi (Tunisia)

Co-authors: Rahma Saidane, Racem Choura, Asma Khallouli, Ahmed Arfaoui, Afef Maalej, Riadh Rannen

Purpose

To evaluate peripapillary microvascular changes in patients with acute non-arteritic anterior ischaemic optic neuropathy (NAION), using optical coherence tomography angiography (OCT-A).

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia.

Methods

We conducted a cross sectional study including 12 eyes of 12 patients with acute NAION , within 7 days after onset of symptoms and 24 eyes of 24 healthy age and sex-matched control subjects. The enrollment has been run between September 2020 and February 2021. All included individuals underwent a complete ophthalmic examination including visual acuity, anterior and posterior segment examination and Spectral Domain OCTA. OCTA scans were performed using AngioVue software of the Optovue RTVue XR Avanti. 4.5 mm × 4.5 mm images for the Radial Peripapillary Capillaries (RPC) were obtained. Peripapillary Retinal Nerve Fiber Layer (RNFL) thickness, whole image (wi), inside disc (id) and peripapillary (pp) vessel densities were evaluated.

Results

The mean age of the NAION and normal subjects was 65 (61–79) and 66 (59–80) years (p=0.3). OCT-A showed a global a decrease in all peripapillary vessel densities (VDs) in eyes with NAION (52.48±4.2%) compared with normal eyes (62.3±4.4%) (p<0.001). The RNFL thikness analysis revealed a thicknnig ineyes with NAION (120.7±7.8%) compared with controls (95±4.0%) (p<0.001). In patients (7 eyes) with resolution of optic disc oedema, a repeated OCT-A analysis at one month revealed an improvement of the peripapillary VDs by 7.1±3.7% with normalization of the RNFL thickness (p=0.035).There was a negative correlation between the RPC VDs and the final BCVA (R=-0.48 ;p=0.036).

Conlusions

Using OCT-A, we revealed a global reduction of peripapillary densities at the acute stage of NAION, followed by partial subsequent recovery. Further studies are needed to establish the value of OCT-A for assesing the NAION .

Financial Disclosure

The authors declare no conflict of interest.