Optical Coherence Tomography Angiography in a Patient with Optic Atrophy After Non-arteritic Anterior Ischaemic Optic Neuropathy

Abstract

A 75-year-old female noticed a lower visual field (VF) defect in the right eye. A diagnosis of non-arteritic anterior ischaemic optic neuropathy (NAION) was made. The lower VF defect in the right eye did not change after onset. Optical coherence tomography (OCT) angiograms on the disc and the macula showed decreased retinal perfusion in the upper retina of the right eye. Retinal nerve fibre layer loss and ganglion cell complex loss in the upper retina were also seen in the right eye. OCT angiography could non-invasively detect the decrease of the retinal perfusion due to NAION.

Retinal and Choroidal Microvasculature in Nonarteritic Anterior Ischemic Optic Neuropathy: An Optical Coherence Tomography Angiography Study

“…Rarefaction of RPC in OCT-A has been reported as a major factor associated with severity of optic neuropathies. 19,[24][25][26] Concerning NAION, we observed, as previous authors 20,21,[27][28][29][30] have, low RPC vessel density in these subjects. This change has already been observed through delayed filling with FA.…”

Reduction of Peripapillary Vessel Density by Optical Coherence Tomography Angiography from the Acute to the Atrophic Stage in Non-Arteritic Anterior Ischaemic Optic Neuropathy

“…These results are in line with the results of previous reports using Optovue [4][5][6][7][8][9][10][11].…”

“…Several studies have found a dropout of microvasculature in peripapillary superficial retina in patients with NAION using OCT-A [3][4][5][6][7][8][9][10][11]. Most of this information has been obtained from AngioVue (OptoVue).…”

“…A decrease in the peripapillary microvasculature has been reported in acute [3][4][5][6] and chronic NAION [5,[7][8][9][10][11]. Most studies have used OCT-A Angiovue (Optovue) providing quantitative values for vessel and flow density.…”

Optical Coherence Angiographic Demonstration of Retinal Changes From Chronic Optic Neuropathies

“…Decreased peripapillary capillary loss was also recently been demonstrated in a few cases of NAION by others. 11,12 However, the location of ischaemia in anterior ischaemic optic neuropathy is thought to occur in the optic nerve head, with the circulation derived from the posterior ciliary arteries, and not in the superficial peripapillary retinal capillary plexus, which is derived from the branches of the central retinal artery. Other causes of optic neuropathy, such as optic neuritis and trauma, are not thought to have ischaemia as an underlying cause of the disease process, and these cases also showed similar loss of the peripapillary vessel density on OCT angiography in our series.…”