Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes: A Clinical and OCT Comparison

HONDUR A. M., Moazami G., Hondur G., Tezel T. H.

Ophthalmology, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1016/j.ophtha.2024.09.008
  • Dergi Adı: Ophthalmology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, MEDLINE
  • Anahtar Kelimeler: Epipapillary membrane, Nonarteritic ischemic optic neuropathy, Posterior vitreous detachment, Vitreopapillary traction, Vitreovascular attachment
  • Gazi Üniversitesi Adresli: Evet

Özet

Purpose: To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects. Design: Case-control study. Participants and Controls: Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II). Methods: The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes). Main Outcome Measures: The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes. Results: The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes. Conclusions: Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.