Deep-Layer Microvasculature Dropout by Optical Coherence Tomography Angiography and Microstructure of Parapapillary Atrophy

作者：Suh Min Hee; Zangwill Linda M; M****astas Patricia Isabel C; Belghith Akram; Yarmohammadi Adeleh; Akagi Tadamichi; Diniz Filho Alberto; Saunders Luke; Weinreb Robert N^*

来源：Investigative Ophthalmology & Visual Science, 2018, 59(5): 1996-2005.

DOI：10.1167/iovs.17-23046

• deep-layer microvasculature dropout
• parapapillary atrophy
• optical coherence tomography angiography

PURPOSE. To investigate the association between the microstructure of beta-zone parapapillary atrophy (beta PPA) and parapapillary deep-layer microvasculature dropout assessed by optical coherence tomography angiography (OCT-A).
METHODS. Thirty-seven eyes with bPPA devoid of the Bruch's membrane (BM) (gamma PPA) ranging between completely absent and discontinuous BM were matched by severity of the visual field (VF) damage with 37 eyes with fully intact BM (beta PPA(+BM)) based on the spectral-domain (SD) OCT imaging. Parapapillary deep-layer microvasculature dropout was defined as a dropout of the microvasculature within choroid or scleral flange in the bPPA on the OCT-A. The widths of bPPA, gamma PPA, and beta PPA(+BM) were measured on six radial SD-OCT images. Prevalence of the dropout was compared between eyes with and without gamma PPA. Logistic regression was performed for evaluating association of the dropout with the width of bPPA, gamma PPA, and beta PPA(+BM), and the gamma PPA presence.
RESULTS. Eyes with gamma PPA had significantly higher prevalence of the dropout than did those without gamma PPA (75.7% versus 40.8%; P = 0.004). In logistic regression, presence and longer width of the gamma PPA, worse VF mean deviation, and presence of focal lamina cribrosa defects were significantly associated with the dropout (P < 0.05), whereas width of the beta PPA and beta PPA(+BM), axial length, and choroidal thickness were not (P > 0.10).
CONCLUSIONS. Parapapillary deep-layer microvasculature dropout was associated with the presence and larger width of gamma PPA, but not with the beta PPA(+BM) width. Presence and width of the exposed scleral flange, rather than the retinal pigmented epithelium atrophy, may be associated with deep-layer microvasculature dropout.

• 出版日期2018-4