PurposeTo assess macular and peripapillary vessel density and neurodegeneration in eyes with and without microcystic macular edema (MME) in neuromyelitis optica spectrum disorder (NMOSD) patients while investigating their association with visual impairment and disease disability.MethodsThis is a cross-sectional study. A total of 52 eyes from 29 NMOSD patients were recruited, including 8 eyes with MME from 7 patients. Optical coherence tomography angiography (OCTA) images were analyzed to quantify the radial papillary capillary density (RPCD), and the density of macular microvascular network in both the superficial retinal capillary plexus (SRCP) and the deep retinal capillary plexus (DRCP). Thicknesses of the neural retinal layers centered on the fovea and the optic nerve head were also collected by OCT. Best-corrected visual acuity (BCVA) and Expanded Disability Status Scale (EDSS) scores were assessed for all patients. Microvascular densities and retinal sublayer thicknesses were compared among groups, and correlations of these vascular and structural parameters with BCVA and EDSS scores were determined.ResultsPatients with NMOSD and MME had significantly decreased visual acuity and worse EDSS score than patients without MME (P = 0.01 and 0.002, respectively). The vessel density in SRCP and RPCD were significantly lower in eyes with MME and ON compared to that of eyes with ON but without MME and eyes without MME or ON. Impairment of visual acuity and disease severity were significantly negatively associated with the reduction of SRCP vessel density and RPCD but were not related to DRCP vessel density.ConclusionsMME were correlated with worse visual impairment and disability in NMOSD patients. Sparse SRCP vessel density and RPCD were observed in NMOSD MME eyes and correlated with worse BCVA and EDSS scores.

中文翻译：

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视觉功能和残疾与视神经脊髓炎谱系障碍患者的微囊性黄斑水肿、黄斑和视乳头周围血管密度有关

目的评估视神经脊髓炎谱系障碍 (NMOSD) 患者伴有和不伴微囊性黄斑水肿 (MME) 的黄斑和视乳头周围血管密度和神经变性，同时调查它们与视力障碍和疾病残疾的关系。方法这是一项横断面研究。共招募了来自 29 名 NMOSD 患者的 52 只眼，其中包括来自 7 名患者的 8 只眼 MME。分析光学相干断层扫描血管造影 (OCTA) 图像以量化径向乳头毛细血管密度 (RPCD) 以及视网膜浅层毛细血管丛 (SRCP) 和深部视网膜毛细血管丛 (DRCP) 中的黄斑微血管网络密度。OCT 还收集了以中央凹和视神经乳头为中心的神经视网膜层的厚度。评估所有患者的最佳矫正视力 (BCVA) 和扩展残疾状态量表 (EDSS) 评分。比较各组微血管密度和视网膜亚层厚度，并确定这些血管和结构参数与 BCVA 和 EDSS 评分的相关性。P= 0.01 和 0.002，分别）。与患有 ON 但没有 MME 的眼睛和没有 MME 或 ON 的眼睛相比，患有 MME 和 ON 的眼睛中 SRCP 和 RPCD 的血管密度显着降低。视力损害和疾病严重程度与 SRCP 血管密度和 RPCD 的降低显着负相关，但与 DRCP 血管密度无关。结论 MME 与 NMOSD 患者更严重的视力损害和残疾相关。在 NMOSD MME 眼中观察到稀疏 SRCP 血管密度和 RPCD，并且与较差的 BCVA 和 EDSS 评分相关。