Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes: A Clinical and OCT Comparison.

IF 13.1 1区医学 Q1 OPHTHALMOLOGY Ophthalmology Pub Date : 2024-09-12 DOI:10.1016/j.ophtha.2024.09.008

Ahmet M Hondur, Golnaz Moazami, Gozde Hondur, Tongalp H Tezel

{"title":"Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes: A Clinical and OCT Comparison.","authors":"Ahmet M Hondur, Golnaz Moazami, Gozde Hondur, Tongalp H Tezel","doi":"10.1016/j.ophtha.2024.09.008","DOIUrl":null,"url":null,"abstract":"Purpose: To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects.Design: Case-control study.Participants and controls: Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II).Methods: The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes).Main outcome measures: The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes.Results: The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes.Conclusions: Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.Financial disclosure(s): Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ophtha.2024.09.008","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects.

Design: Case-control study.

Participants and controls: Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II).

Methods: The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes).

Main outcome measures: The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes.

Results: The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes.

Conclusions: Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.

Financial disclosure(s): Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

非动脉炎性缺血性视神经病变与健康眼的玻璃体毛细血管发现：临床与 OCT 比较。

目的：研究非动脉缺血性视神经病变（NAION）的玻璃体-毛细血管界面，寻找可能导致视神经灌注缺陷的特征：病例对照研究：将NAION患者（研究组）与有拥挤视盘（对照组I）和无拥挤视盘（对照组II）的非NAION健康患者进行比较：方法：使用高分辨率 OCT 扫描对 32 例非内视网膜视网膜病变患者的玻璃体乳头界面进行研究。将结果与两个对照组进行比较，对照组由年龄、性别和屈光度匹配的非 NAION 患者组成，分别为视盘拥挤组（对照组 I：31 只眼）和视盘非拥挤组（对照组 II：32 只眼）：主要结果指标：玻璃体后脱离（PVD）、玻璃体毛细血管和玻璃体血管附着物以及毛细血管上膜的发生率：各组黄斑上的PVD发生率相似（NAION：62.5%，对照组I：61.3%，对照组II：65.6%，P=0.93），而后玻璃体仍附着在拥挤的玻璃盘上的发生率明显更高（NAION：81.2%，对照组I：83.9%，对照组II：43.7%，P=0.0005）。与不拥挤的圆盘相比，拥挤圆盘上的局灶玻璃体毛细血管附着率更高（NAION：72.2%，拥挤对照组 I：58.7%，不拥挤对照组 II：19.1%，P=0.007）。在NAION眼中观察到玻璃血管附着（NAION：69%，拥挤对照组I：3%，非拥挤对照组II：6%，P=0.00001）和致密的毛细血管上膜：结论：拥挤的视盘可能具有更强的玻璃体毛细血管附着力。这些附着物与视神经血管的密切关系可能会导致玻璃体凝胶鞘内强大牵引力的传递，尤其是在黄斑 PVD 之后。这种传递的机械力可能会使血管壁变形，并破坏非视神经损伤中的血流。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Ophthalmology 医学-眼科学

CiteScore

22.30

自引率

3.60%

发文量

412

审稿时长

18 days

期刊介绍： The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.

期刊最新文献

Multimodal Imaging Findings in Limbal Stem Cell Deficiency due to Hydroxyurea. Visual Loss in Geographic Atrophy: Learnings From the Lampalizumab Trials. Concentric Macular Rings Sign in a Patient with Variant Turner Syndrome. Dandelion-like Retinal Capillary Hamartoma. Hurricane Keratopathy Induced by Anticancer Drug S-1.