Comparison of OCT Structural Parameters and OCTA-Measured Retinal Vessel Density and Peripapillary Choroidal Microvasculature in Glaucoma and Optic Neuritis From Multiple Sclerosis or Neuromyelitis Optica.

AIMS: To compare peripapillary retinal nerve fiber layer (pRNFL), choroidal microvascular dropout (CMvD) and vessel density (pVD), as well as macular ganglion cell complex (GCC) and vessel density (mVD) in eyes with glaucoma and optic neuritis (ON) due to multiple sclerosis (MS-ON) or neuromyelitis optica spectrum disorder (NMOSD-ON) using OCT and OCT angiography (OCTA), and to assess its correlations with visual acuity and visual field (VF) parameters.

METHODS

Thirty-one eyes (16 patients) with glaucomatous optic neuropathy (GON), 26 eyes (16 patients) with MS-ON, 19 eyes (12 patients) with NMOSD-ON, and 53 healthy eyes (27 subjects) underwent 24-2 VF, OCT, and OCTA. The pRNFL thickness, pVD, and CMvD, as well as macular GCC thickness and mVD, were analyzed and compared using generalized estimating equations. Area under the receiver operating characteristic curves was calculated.

RESULTS

All disease groups showed significantly reduced structural parameters compared to controls. MS-ON and NMOSD-ON did not differ and demonstrated greater GCC thinning than GON despite similar pRNFL thickness (except nasally). mVD did not significantly differ among disease groups. In contrast, superficial and deep pVD distinguished the disease groups from controls and were significantly lower in nasal and temporal sectors in MS-ON and particularly in NMOSD-ON compared to GON. Although CMvD occurred in all groups, it was significantly more frequent and extensive in GON. Significant correlations were found between OCTA and OCT and visual function parameters in MS-ON and NMOSD-ON but not in GON eyes.

CONCLUSIONS

OCT and OCTA parameters seem to differentiate GON, MS-ON, and NMOSD-ON from controls, but substantial overlap exists among the diseases. The presence of CMvD, particularly when extensive, was more commonly observed in GON, although its presence in other groups limits its diagnostic specificity. Trial Registration: Brazilian Clinical Trials Registry: 76722517.2.0000.0068.