Evaluation of optic nerve head vessels density changes after phacoemulsification cataract surgery using optical coherence tomography angiography

AIM: To evaluate optic nerve head (ONH) vessel density (VD) changes after cataract surgery using optical coherence tomography angiography (OCTA). METHODS: This was a prospective observational study. Thirty-four eyes with mild/moderate cataracts were included. ONH scans were obtained before and 3mo after cataract surgery using OCTA. Radial peripapillary capillary (RPC) density, all VD, large VD and retinal nerve fiber layer thickness (RNFLT) in total disc, inside disc, and different peripapillary sectors were assessed and analyzed. Image quality score (QS), fundus photography grading and best-corrected visual acuity (BCVA) were also collected, and correlation analyses were performed between VD change and these parameters. RESULTS: Compared with baseline, both RPC and all VD increased in inside disc area 3mo postoperatively (from 47.5%±5.3% to 50.2%±3.7%, and from 57.87%±4.30% to 60.47%±3.10%, all P<0.001), but no differences were observed in peripapillary area. However, large VD increased from 5.63%±0.77% to 6.47%±0.72% in peripapillary ONH region (P<0.001). RPC decreased in inferior and superior peripapillary ONH parts (P=0.019, <0.001 respectively). There were obvious negative correlations between RPC change and large VD change in inside disc, superior-hemi, and inferior-hemi (r=-0.419, -0.370, and -0.439, P=0.017, 0.044, and 0.015, respectively). No correlations were found between VD change and other parameters including QS change, fundus photography grading, postoperative BCVA, and postoperative peripapillary RNFLT. CONCLUSION: RPC density and all VD in the inside disc ONH region increase 3mo after surgery in patients with mild to moderate cataract. No obvious VD changes are found in peripapillary area postoperatively.     

Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

AIM: To assess the differences in average and sectoral peripapillary retinal nerve fiber layer (pRNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in patients with non-arteritic anterior ischemic neuropathy (NAION) compared with those with primary open angle glaucoma (POAG). METHODS: A comprehensive literature search of the PubMed, Cochrane Library, and Embase databases were performed prior to October, 2021. Studies that compared the pRNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included. The weighted mean difference (WMD) with 95% confidence interval (CI) was used to pool continuous outcomes. RESULTS: Ten cross-sectional studies (11 datasets) comprising a total of 625 eyes (278 NAION eyes, 347 POAG eyes) were included in the qualitative and quantitative analyses. The pooled results demonstrated that the superior pRNFL was significantly thinner in NAION eyes than in POAG eyes (WMD=-6.40, 95%CI: -12.22 to -0.58, P=0.031), whereas the inferior pRNFL was significant thinner in POAG eyes than in NAION eyes (WMD=11.10, 95%CI: 7.06 to 15.14, P≤0.001). No difference was noted concerning the average, nasal, and temporal pRNFL thickness (average: WMD=1.45, 95%CI: -0.75 to 3.66, P=0.196; nasal: WMD= -2.12, 95%CI: -4.43 to 0.19, P=0.072; temporal: WMD= -1.24, 95%CI: -3.96 to 1.47, P=0.370). CONCLUSION: SD-OCT based evaluation of inferior and superior pRNFL thickness can be potentially utilized to differentiate NAION from POAG, and help to understand the different pathophysiological mechanisms between these two diseases. Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.     

青光眼与非炎症性缺血型视神经病变的傅立叶OCT扫描视神经形态学对比

目的 比较青光眼与非炎症性缺血型视神经病变(non-arteritic ischemic optic neuropathy,NAION)患者患眼的视盘及盘周视网膜神经纤维层(peripapillary retinal nerve fiber layer,pRNFL)参数变化情况及诊断能力.方法 选择我院眼科年龄≥40岁就诊患者71例(71眼).受试者分为青光眼组26例、NAION组15例、对照组30例,排除视野缺损范围大于两个象限或等效球镜度数大于±6D的受试眼以及发病时间小于6个月的NAION患眼.所有患者均接受眼部常规检查,使用傅立叶OCT测量视盘及pRNFL各参数.结果 3组之间除视盘面积外(P =0.059),其余视盘及pRNFL各参数差异均有统计学意义(均为P＜0.05).经LSD两两比较发现:青光眼组的视杯面积(1.438±0.714)mm2最大(均为P ＜0.05),盘沿面积(0.965 ±0.652)mm2最小(均为P＜0.05),盘沿容积和视神经盘容积[(0.103 ±0.089)mm3、(0.195±0.168)mm3]最小(均为P＜0.05),视杯容积(0.482 ±0.420)mm3最大(均为P ＜0.05),杯盘比最大(均为P＜0.05);NAION组的视杯面积(0.493±0.344) mm2最小(均为P＜0.05),盘沿面积(1.255±0.294) mm2与对照组(1.243±0.509) mm2差异无统计学意义(P＞0.05),盘沿容积(0.196±0.094)mm3、视神经盘容积(0.339±0.109) mm3与对照组差异均无统计学意义(均为P＞0.05),视杯容积(0.083 ±0.073)mm3最小(均为P＜0.05),杯盘比最小(均为P＜0.05).在pRNFL方面,经LSD两两比较发现:3组在平均值及TU、ST、SN、NU、IT区之间两两比较差异均有统计学意义(均为P＜0.05);在NL、IN、TL区,青光眼组与对照组两两比较差异均有统计学意义(均为P ＜0.05).将青光眼组与对照组进行AROC分析发现:视盘参数中除视盘面积外(P＞0.05),其他参数及所有pRNFL各参数差异均有统计学意义(均为P＜0.05).将NAION组与对照组进行AROC分析发现:pRNFL中的上方(即ST、SN区)、鼻上(即NU区)和下方偏颞侧(即IT区)AROC差异均有统计学意义(均为P＜0.05),视盘所有参数及pRNFL其余部位差异均无统计学意义(均为P ＞0.05).将NAION组与青光眼组进行AROC分析发现:视盘参数中视杯面积、视杯容积、杯盘比(包括面积、水平和垂直)的AROC差异均有统计学意义(均为P＜0.05),而pRNFL中的颞上方(即TU区)、鼻上方(即NU区)和平均值AROC差异均有统计学意义(均为P＜0.05),其余部位差异均无统计学意义(均为P＞0.05).结论 通过傅立叶OCT检测可发现青光眼与NAION在视盘及pRNFL方面的差异,为理解此两种视神经疾病的发病特点及鉴别诊断提供临床依据.     

Analysis of optic disc damage by optical coherence tomography in terms of therapy in non-arteritic anterior ischemic optic neuropathy

This study aimed to assess the relationship between the rate of nerve fiber loss in non-arteritic anterior ischemic optic neuropathy (NAION) and time delay before therapy. Total 24 patients received the same treatment within or after 2wk (early and late groups). There were significantly lower level of destruction of nerve fibers (P=0.0014) and significantly better visual field sensitivity (P=0.039) in early group. The results indicate that therapy should be started within 2wk. The degree of ischemic damage due to NAION correlates well with retinal nerve fiber layer thickness and the ischemia-induced decrease in visual field sensitivity.     

特发性脱髓鞘性视神经炎所致视神经萎缩盘周视网膜神经纤维层厚度及黄斑厚度的定量研究

目的  应用相干光断层扫描（OCT）分析特发性脱髓鞘性视神经炎（IDON）所致视神经萎缩眼的视网膜神经纤维层厚度（RNFLT）和黄斑厚度（MT）的变化及其与病程和最佳矫正视力（BCVA）的相关性。设计  回顾性病例系列。研究对象  眼底表现视盘色苍白确定为视神经萎缩的IDON患者16例（16眼）及性别年龄匹配的健康对照23例（23眼）。方法  回顾OCT和BCVA检查结果,对比分析两组RNFLT和MT的差异,平均RNFLT和黄斑容积平均厚度的关系以及RNFLT和MT与病程和BCVA的线性相关关系。主要指标  平均（360°）RNFLT、四个象限RNFLT、黄斑容积平均厚度、ETDRS栅格9个分区的MT、病程及BCVA。结果  与正常对照相比,病例组360°平均和四个象限RNFLT均显著变薄（P均=0.00）,除中心子区外（P=0.25）,其余分区MT和黄斑容积平均厚度均显著变薄（P均=0.00）。平均RNFLT与黄斑容积平均厚度存在直线相关关系（r=0.662,P=0.01）,平均RNFLT和黄斑容积平均厚度与病程均无直线相关关系（P=0.70,P=0.13）。平均RNFLT和黄斑容积平均厚度与BCVA均无直线相关关系（P=0.80,P=0.28）。结论  有视神经萎缩的IDON患者除黄斑中心子区MT无显著变化外,其余分区MT和所有象限RNFLT均显著变薄,黄斑容积平均厚度与平均RNFLT存在线性相关关系,RNFLT越薄黄斑容积平均厚度越薄。RNFLT和黄斑容积平均厚度与病程和BCVA无线性相关关系。（眼科, 2013, 22: 130-134）     

Structural measurements and vessel density of spectral-domain optic coherence tomography in early, moderate, and severe primary angle-closure glaucoma

AIM: To compare the macular ganglion cell-inner plexiform layer (GCIPL) thickness, retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters, and retinal vessel density (VD) measured by spectral-domain optical coherence tomography (SD-OCT) and analyze the correlations between them in the early, moderate, severe primary angle-closure glaucoma (PACG) and normal eyes. METHODS: Totally 70 PACG eyes and 20 normal eyes were recruited for this retrospective analysis. PACG eyes were further separated into early, moderate, or severe PACG eyes using the Enhanced Glaucoma Staging System (GSS2). The GCIPL thickness, RNFL thickness, ONH parameters, and retinal VD were measured by SD-OCT, differences among the groups and correlations within the same group were calculated. RESULTS: The inferior and superotemporal sectors of the GCIPL thickness, rim area of ONH, average and inferior sector of the retinal VD were significantly reduced (all P<0.05) in the early PACG eyes compared to the normal and the optic disc area, cup to disc ratio (C/D), and cup volume were significantly higher (all P<0.05); but the RNFL was not significant changes in early and moderate PACG. In severe group, the GCIPL and RNFL thickness were obvious thinning with retinal VD were decreasing as well as C/D and cup volume increasing than other three groups (all P<0.01). In the early PACG subgroup, there were significant positive correlations between retinal VD and GCIPL thickness (except superonasal and inferonasal sectors, r=0.573 to 0.641, all P<0.05), superior sectors of RNFL thickness (r=0.055, P=0.049). More obvious significant positive correlations were existed in moderate PACG eyes between retinal VD and superior sectors of RNFL thickness (r=0.650, P=0.022), and temporal sectors of RNFL thickness (r=0.740, P=0.006). In the severe PACG eyes, neither GCIPL nor RNFL thickness was associated with retinal VD. CONCLUSION: The ONH damage and retinal VD loss appears earlier than RNFL thickness loss in PACG eyes. As the PACG disease progressed from the early to the moderate stage, the correlations between the retinal VD and RNFL thickness increases.     

定量分析单眼视网膜静脉阻塞患者视盘区变化

目的:通过光学相干断层扫描血管成像技术(OCTA)定量分析单眼视网膜静脉阻塞(RVO)患者视盘旁放射状毛细管血流密度(ppVD)与视盘旁视网膜神经纤维层(pRNFL)厚度的变化及相关性。方法:前瞻性观察性研究。纳入2021-01/12于安徽理工大学第一附属医院眼科就诊的单眼RVO患者43例,其中RVO患眼43眼作为患侧组,未受累眼43眼作为对侧组,同时期选取年龄、性别与RVO患者相匹配的健康志愿者21例42眼作为对照组。采用OCTA测量视盘内血流密度(VD)、视盘周围VD及其上侧(pS)、下侧(pI)、颞侧上方(TS)、上方颞侧(ST)、上方鼻侧(SN)、鼻侧上方(NS)、鼻侧下方(NI)、下方鼻侧(IN)、下方颞侧(IT)、颞侧下方(TI)的ppVD与pRNFL厚度,分析纳入受检者ppVD和pRNFL厚度的特征性改变及相关性。结果:与对照组相比,患侧组视盘内VD、视盘周围整体VD及pS、pI、TI、ST、SN侧ppVD均下降,对侧组仅视盘内VD降低(均P<0.05)。与对照组相比,患侧组TS侧pRNFL厚度升高,对侧组ST和IT侧pRNFL厚度降低(均P<0.01)。典型...     

基于OCTA的白内障超声乳化术后黄斑区视网膜厚度和血管密度分析

目的利用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)评估白内障超声乳化术后黄斑区视网膜厚度和血管密度的改变。方法纳入47例(57眼)白内障患者,分别在白内障超声乳化术前及术后1周、1个月和3个月使用OCTA检查患眼黄斑中心凹、黄斑中心凹旁、黄斑中心凹周边视网膜厚度和黄斑区视网膜浅层、深层的微血管密度以及黄斑中心凹无血管区(foveal avascular zone,FAZ)面积的变化。结果与术前相比,术后1个月和3个月黄斑中心凹、黄斑中心凹旁和黄斑中心凹周边视网膜全层厚度均显著增加(均为P<0.05),主要表现在内层视网膜的增加上。术后1周、1个月、3个月,黄斑中心凹旁及黄斑中心凹周边视网膜浅层血管密度与术前相比差异均无统计学意义(均为P>0.05),仅术后1个月视网膜深层黄斑中心凹周边血管密度显著高于术前(P<0.05)。术后1个月和3个月黄斑FAZ面积分别为(0.42±0.23)mm²和(0.34±0.17)mm²,显著低于术前的(0.73±0.9...     

Quantifying peripapillary vessel density and retinal nerve fibre layer in type 1 diabetic children without clinically detectable retinopathy using OCTA

AIM: To quantify changes in radial peripapillary capillary vessel density (ppVD) and the peripapillary retinal nerve fiber layer (pRNFL) in children with type 1 diabetes without clinical diabetic retinopathy by optical coherence tomography angiography (OCTA), providing a basis for early retinopathy in children with type 1 diabetes. METHODS: This was a retrospective study. A total of 30 patients (3–14y) with type 1 diabetes without clinical diabetic retinopathy (NDR group) were included. A total of 30 age-matched healthy subjects were included as the normal control group (CON group). The HbA1c level in the last 3mo was measured once in the NDR group. The pRNFL thickness and ppVD were automatically measured, and the mean pRNFL and ppVD were calculated in the nasal, inferior, temporal, and superior quadrants. The changes in ppVD and pRNFL in the two groups were analyzed. RESULTS: Compared with CON group, the nasal and superior ppVDs decreased in the NDR group (all P<0.01). The thickness of the nasal pRNFL decreased significantly (P<0.01), while the inferior, temporal and superior pRNFLs slightly decreased but not significant in the NDR group (all P>0.05). Person and Spearman correlation analysis of ppVD and pRNFL thickness in each quadrant of the NDR group showed a positive correlation between nasal and superior (all P<0.01), while inferior and temporal had no significant correlation (all P>0.05). There was no significant correlation between the HbA1c level and ppVD and pRNFL in any quadrant (all P>0.05). There was no significant correlation between the course of diabetes mellitus and ppVD and pRNFL in any quadrant (all P>0.05). CONCLUSION: ppVD and pRNFL decrease in eyes of children with type 1 diabetes before clinically detectable retinopathy and OCTA is helpful for early monitoring．     

光学相干断层扫描血流成像技术(OCTA)在视网膜静脉阻塞中的应用

光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)是一种近年来新兴的无创、快速、高分辨率的眼底血管成像技术.OCTA拥有分层观察不同层面的视网膜血管形态,量化血流灌注的独特优势,现广泛应用于各类眼底血管疾病的诊断及随访.视网膜静脉阻塞是一种常见的眼底血管病变,本文对OCTA在视网膜静脉阻塞的应用进行综述.     

应用OCT观察早期糖尿病视网膜病变患者视网膜神经纤维层的厚度变化

目的：研究和分析早期糖尿病视网膜病变患者视盘周围视网膜神经纤维层和黄斑部视网膜厚度的变化,揭示不同程度的早期糖尿病视网膜病变患者视网膜神经纤维层( RNFL)及黄斑部视网膜厚度变化的趋势。
　　方法：临床病例对照研究。选取我院2012-09/2013-01确诊的早期2型糖尿病视网膜病变患者60例120眼,分为无视网膜病变组( NDR)20例40眼及合并轻、中度非增殖性糖尿病视网膜病变组( NPDR)40例80眼,对照组为正常人20例40眼,应用光学相干断层成相分别以RNFL扫描模式(视盘中点为中心,直径为3.45 mm环形扫描)和黄斑部视网膜厚度扫描模式(黄斑中心凹为中心。直径1000μm的区域);测量正常人与早期糖尿病视网膜病变患者视盘周围RNFL厚度和黄斑区视网膜厚度。
　　结果：与正常对照组相比, NDR组除下象限RNFL变薄差异有统计学意义( P<0.05);视盘周围RNFL厚度及其它各象限差异无统计学意义( P>0.05),轻度NPDR组视盘周围平均值、下象限 RNFL 厚度差异有统计学意义( P<0.05);中度 NPDR 组视盘周围平均值、上象限、下象限RNFL厚度下降差异均有统计学意义( P<0.05)。 NPDR组,NDR组和对照组三组比较各象限 RNFL 厚度下降;NDR组、轻度NPDR与中度NPDR组相比,黄斑部视网膜厚度差异有统计学意义(P<0.05),后者视网膜厚度逐渐增加。
　　结论：在早期糖尿病视网膜病变,视盘周围RNFL厚度随病变程度逐渐降低,而黄斑部视网膜厚度却逐渐增加, OCT能定性、定量地观察早期糖尿病视网膜病变的程度。     

糖尿病性视神经病变的OCT图像特点分析

目的：回顾分析糖尿病性视神经病变( diabetic optic neuropathy, DON )的相干光断层成像( optical coherence tomography,OCT)的特点。
　　方法：回顾性系列病例研究。选择2013-12/2015-10西安交通大学医学院第二附属医院眼科门诊和内分泌科会诊期间诊断为2型糖尿病且伴有眼底病变的患者175例350眼的临床资料,记录患者的全身检查情况和疾病史,阅读所有患者的彩色眼底照相、荧光素眼底血管造影( fluorescein fundus angiography,FFA)、OCT的影像结果,并进行分析统计。
　　结果：通过FFA 检查视乳头具有异常荧光表现,确定有DON的有49例90眼,占25.7%。 OCT结果显示DON 90眼中15眼(16.7%)表现为视神经形态大致正常;20眼(22.2%)表现为视杯凹陷变小或消失,筛板前组织肿胀,同时伴有盘周神经纤维层水肿;26眼(28.9%)表现为视杯深陷,杯盘比变大;18眼(20.0%)表现为视盘内或视盘表面组织增生;11眼(12.3%)玻璃体视乳头牵拉,视盘边缘抬高。在FFA中有相同荧光表现的DON患眼,在OCT检查可表现出不同的组织形态。
　　结论：FFA从视神经的血循环状态变化定义DON,而OCT可以发现FFA所不能显示的视神经组织形态的变化,从而更清晰视神经病变的位置和原因,为治疗提供依据。OCT无创、快捷、费用低、可重复性强等优点有利于DON患者的复查及治疗效果追踪。     

Optical coherence tomography angiography of optic disc perfusion in non-arteritic anterior ischemic optic neuropathy

AIM: To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy (NAION) eyes with normal eyes. METHODS: The optic disc blood flow densities of diagnosed non-acute phase NAION eyes (21 eyes, 14 individuals) and normal eyes (19 eyes, 12 individuals) were detected via Optovue optical coherence tomography angiography (OCTA). The optic disc blood flow was measured via Image J software. Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis. RESULTS: The average percentage of the optic disc non-perfusion areas in the non-acute phase NAION patients (17.84%±6.18%) was increased, when compared to the normal control eyes (8.61%±1.65%), and the difference was statistically significant (P<0.01). Moreover, there was a proportional correlation between the visual field mean defect (MD) and the optic disc non-perfusion area percentage, and the relationship was statistically significant (t=3.65, P<0.01, R2=0.4118). In addition, the critical correlation between the best corrected visual acuity (BCVA) and the optic disc non-perfusion area percentage was statistically significant (t=4.32, P<0.01, R2=0.4957). CONCLUSION: The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes. Both the BCVA and MD were correlated with the optic disc flow detected, revealing that OCTA may be valuable in the diagnosis and estimation of NAION.     

OCT检测视网膜神经纤维层厚度与视盘大小的相关性研究

目的探讨光学相干断层扫描(OCT)技术常规扫描模式检测视网膜神经纤维层(RNFL)厚度是否受视盘大小的影响,为其准确客观地应用于临床提供理论依据。方法对年龄在18～30岁的正常人118名(118眼)应用OCT常规扫描模式对盘周RNFL厚度进行检测。应用眼底照相检测视盘面积、水平及垂直直径。分析RNFL厚度与视盘大小的相关性。结果全周平均RNFL厚度值,上方、下方、鼻侧、颞侧象限RNFL厚度值分别为(112.02±10.13)、(135.16±19.04)、(138.56±16.46)、(71.56±14.91)、(97.43±17.98)μm。视盘垂直、水平直径及面积分别为(1.88±0.25)mm2、(1.79±0.19)mm2及(2.67±0.44)mm2。RNFL厚度值与视盘面积有正相关性(P<0.05)。结论OCT常规扫描模式检测RNFL厚度受视盘大小的影响。     

Acute changes in ganglion cell layer thickness in ischemic optic neuropathy compared to optic neuritis using optical coherence tomography

AIM:To elucidate the changes of different ganglion cell layer(GCL)thinning patterns between the optic neuritis(ON)and non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:A prospective,observational study was conducted to evaluate the timing of GCL changes between acute ON and NAION using optical coherence tomography.RESULTS:Thinning on optical coherence tomography in the NAION group occurs as early as 11 d after symptomatic onset of vision loss and follows an altitudinal pattern.The mean superior-inferior GCL thickness difference in the NAION cohort was clinically significant at 5.7μm in the NAION cohort compared to controls of 0.8μm(P=0.032),but not significant in the ON group compared to controls with both groups measuring 1.1μm.Global thinning was significant for the ON group compared to controls at 7.2μm(P=0.011)but not the NAION group compared to controls at 1.35μm.CONCLUSION:These findings suggest that future treatments for NAION should be given early,and possibly before 11 d in order to prevent GCL and irreversible vision loss.     

Optical coherence tomographic findings in optic nerve hypoplasia

We investigated a case of unilateral optic nerve hypoplasia using spectral domain optical coherence tomography (SDOCT). Optical coherence tomography was done on both eyes using 5-line Raster scan for the fovea to analyze the retinal nerve fiber layer thickness, inner retinal layer thickness, outer retinal layer thickness, and optic disc cube scan for the disc. Retinal nerve fiber layer thickness, inner retinal layer thickness, and outer retinal layer thickness were manually measured at 21-points of each five lines, and results were compared between both eyes. Retinal nerve fiber layer thickness and inner retinal layer thickness of optic nerve hypoplasia were significantly thinner than the opposite eye, but there was no significant difference in the thickness of the outer retinal layer between both eyes.     

Evaluation of macular and peri-papillary blood vessel density following uncomplicated phacoemulsification in diabetics using optical coherence tomography angiography

Purpose:The aim of this study was to evaluate the macular and peri-papillary blood vessel density following uncomplicated phacoemulsification in diabetics using optical coherence tomography angiography (OCT-A).Methods:An observational case-control study was conducted on 60 patients eligible for phacoemulsification, divided equally into diabetic and control groups. Both study groups were matching in sex, age, and axial length. We excluded diabetic patients of any form of macular edema or treatment history for macular edema. All study participants were subjected to preoperative OCT and OCT-A, which was repeated for all study population 1 month postoperatively.Results:We had a mean age of 54.5 ± 6.34 years in the non-diabetic group and 57.2 ± 4.09 years in the diabetic group (P = 0.06). There was a significant increase in the mean value of the macular blood vessels density in the nasal area in both study groups (P = 0.047 in non-diabetic group, P = 0.002 in the diabetic group). The percentage of the radial peripapillary capillary plexus vessel density (RPCP VD) change was non-significant on comparing the results for the diabetic group (mean preoperative value = 52.8 ± 4.47, postoperative = 52.0 ± 4.59, P = 0.204, D is the preoperative-postoperative value = 0.8), and also was non-significant for the non-diabetic group (mean preoperative value = 50.9 ± 4.89, postoperative = 52.1 ± 4.89, P = 0. 0.090, D = -1.3). On comparing the results of the diabetic and nondiabetic groups, the RPCP VD D was significantly different (P = 0.034).Conclusion:Uncomplicated phacoemulsification results in increase of the nasal macular blood vessel density in the normal population and in diabetic patients without retinopathy.     

Evaluation of optical coherence tomography angiography findings in patients with multiple sclerosis

Purpose:To evaluate optical coherence tomography angiography findings in patients with multiple sclerosis (MS).Methods:This prospective noninterventional study was conducted on 30 eyes of relapsing-remitting MS patients. Group (1) included 10 eyes with a history of optic neuritis (ON), group (2) included 10 eyes without any history of optic neuritis (MS-ON), and group (3) included 10 eyes of normal age/sex/refraction matched participants. Optical coherence tomography (OCT) and OCT-A (ZEISS Cirrus™ HD-OCT Model 4000 (Carl Zeiss-Meditec, Dublin, CA) of the optic disc were done for all patients.Results:The best-corrected visual acuity was diminished in MS cases, especially in patients with ON with P value <0.001. The retinal nerve fiber layer (RNFL) thickness showed a significant decrease in the average thickness and in all quadrants, notably the temporal quadrant in group 1 (P < 0.001). Ganglion cell layer thickness was diminished in average thickness and in all quadrants in both groups of MS, but only the first group showed statistical significance with P value <0.001). In respect to optic disc perfusion, Average, superficial, and deep vascular density index (AVDI, VDI 1, VDI 2) were statistically significantly lower in groups 1, 2 with (P-value < 0.001).Conclusion:Decreased vascular perfusion of the optic nerve in MS patients, especially in those with ON is strongly correlated with the damage of RNFL and ganglion cell layer detected by OCT.