Optical coherence tomography angiography of optic nerve head and parafovea in multiple sclerosis

Abstract

Aims To investigate swept-source optical coherence tomography (OCT) angiography in the optic nerve head (ONH) and parafoveal regions in patients with multiple sclerosis (MS). Methods Fifty-two MS eyes and 21 healthy control (HC) eyes were included. There were two MS subgroups: 38 MS eyes without an optic neuritis (ON) history (MS −ON), and 14 MS eyes with an ON history (MS +ON). The OCT images were captured by high-speed 1050 nm swept-source OCT. The ONH flow index (FI) and parafoveal FI were quantified from OCT angiograms. Results The mean ONH FI was 0.160±0.010 for the HC group, 0.156±0.017 for the MS−ON group, and 0.140±0.020 for the MS+ON group. The ONH FI of the MS+ON group was reduced by 12.5% compared to HC eyes (p=0.004). A higher percentage of MS+ON eyes had abnormal ONH FI compared to HC patients (43% vs 5%, p=0.01). Mean parafoveal FIs were 0.126±0.007, 0.127±0.010, and 0.129±0.005 for the HC, MS−ON, and MS +ON groups, respectively, and did not differ significantly among them. The coefficient of variation (CV) of intravisit repeatability and intervisit reproducibility were 1.03% and 4.53% for ONH FI, and 1.65% and 3.55% for parafoveal FI. Conclusions Based on OCT angiography, the FI measurement is feasible, highly repeatable and reproducible, and it is suitable for clinical measurement of ONH and parafoveal perfusion. The ONH FI may be useful in detecting damage from ON and quantifying its severity.

Detection of retinal blood vessel changes in multiple sclerosis with optical coherence tomography

“…Wang, et. al., showed lower optic nerve head blood flow in MS patients with a history of ON, compared with both MS patients without a history of ON, and control subjects, which supports such a mechanism in the optic nerve head circulation [25]. They also demonstrated no difference in parafoveal blood flow between controls, MS-ON, and MS + ON, arguing against such a mechanism in the retinal circulation.…”

“…However, these relationships have not been thoroughly explored using OCT. There is a single report of a decrease in relative blood flow to the optic nerve head in MS eyes, measured using OCT angiography [25]. However, this technique is not yet widely available in the clinical setting, compared to quantitative static retinal blood vessel metrics which can be extracted from OCT scans that are acquired using currently available clinical instrumentation [26][27][28].…”

Optical Coherence Angiographic Demonstration of Retinal Changes From Chronic Optic Neuropathies

“…Wang and colleagues also found decreased optic nerve blood flow on OCT angiography in patients with prior optic neuritis, 5 and Ghasemi et al found decreased visibility of the peripapillary capillaries in one case of autoimmune optic neuritis, four cases of NAION, one case of dominant optic atrophy, and four cases of Leber's hereditary optic neuropathy.…”

“…2 OCT angiography is achieved by rapidly scanning the retinal tissue with sequential scans and evaluating the images for particle (blood cell) movement that can be used to construct microvascular density maps. [2][3][4][5] Recent reports indicate that there is decreased optic disc perfusion and peripapillary capillary density on OCT angiography in patients with chronic glaucoma. 4,[6][7][8][9] This has led to speculation that reduced capillary density from OCT angiography in glaucoma eyes provides evidence for a primary role in the pathogenesis of glaucoma.…”

Calibration of optical coherence tomography angiography with a microfluidic chip

“…6,14 Decorrelation is a function of the displacement of scatters (red blood cells) overtime, representing blood flow signals for OCT angiography. Multiple studies have used SSADA to quantify blood flow reduction in neurological disorders [15][16][17] and abnormal circulation in retinal diseases. 10,18 In addition, changes in blood flow due to external stimuli in terms of vessel density and flow index have been reported.…”