AUTHOR=Wei Ruili , Xie Jianyang , Wu Huihui , He Fangping , Meng Fangxia , Liu Jiang , Liang Hui , Zhao Yitian 

TITLE=Superficial Macula Capillary Complexity Changes Are Associated With Disability in Neuromyelitis Optica Spectrum Disorders

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.724946

DOI=10.3389/fneur.2021.724946

ISSN=1664-2295

ABSTRACT=<p><bold>Purpose:</bold> We examined the macular microvascular changes of the macula in neuromyelitis optica spectrum disorder (NMOSD) patients and its association with their disability and other clinical variables.</p><p><bold>Methods:</bold> Thirty-four NMOSD (13 patients without optic neuritis, NMOSD-NON, and 21 patients with a history of optic neuritis, NMOSD-ON) and 44 healthy controls (HCs) were included in the study. Optical coherence tomographic angiography (OCTA) was used to image the superficial (SCP), deep (DCP), and whole capillary plexus (WCP) in a 2.5-mm-diameter concentric circle [excluding the foveal avascular zone (FAZ)]. An algorithm (D<sub>box</sub>) was used to quantify the complexity of the three capillary layers by fractal analysis. We also evaluated the expanded disability scale status (EDSS).</p><p><bold>Results:</bold> D<sub>box</sub> values were significantly reduced in SCP (<italic>p</italic> &lt; 0.001), DCP (<italic>p</italic> &lt; 0.001), and WCP (<italic>p</italic> = 0.003) of NMOSD when compared with HCs. D<sub>box</sub> values were significantly reduced in NMOSD eyes with optic neuritis when compared with healthy controls (<italic>p</italic> &lt; 0.001) and eyes without optic neuritis (<italic>p</italic> = 0.004) in the SCP. In the DCP, eyes with optic neuritis showed significantly reduced D<sub>box</sub> values when compared with eyes without optic neuritis (<italic>p</italic> = 0.016) and healthy controls (<italic>p</italic> &lt; 0.001); eyes without optic neuritis showed significantly reduced D<sub>box</sub> values (<italic>p</italic> = 0.007) in the DCP when compared with healthy controls. A significant negative correlation (Rho = −0.475, <italic>p</italic> = 0.005) was shown between the superficial macula D<sub>box</sub> values and the EDSS in NMOSD patients. Additionally, a negative correlation (Rho = −0.715, <italic>p</italic> = 0.006) was seen in the superficial D<sub>box</sub> values in [e]eyes without optic neuritis and EDSS.</p><p><bold>Conclusions:</bold> Macular microvascular damage in the superficial plexus is associated with disability in NMOSD. Macular microvascular alterations arise independently of the occurrence of ON in NMOSD.</p>