BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic im...BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.展开更多
AIM:To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy(DR)and compare findings in diabetic patients with and without DR.METHODS:PubMed,Web of Science,and Emba...AIM:To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy(DR)and compare findings in diabetic patients with and without DR.METHODS:PubMed,Web of Science,and Embase databases were searched from inception to February 2024.The quality of the included studies was evaluated using a National Institutes of Health(NIH)Quality Assessment tool for Observational Cohort and Cross Sectional Studies.Metaanalysis was conducted to compare the findings of nailfold capillaroscopy between diabetic patients with or without DR.Subgroup analysis was employed to investigate the source of heterogeneity.RESULTS:Totally 12 studies with 1349 diabetic patients were included,of which 628 had DR.The overall quality of included studies was acceptable.Patients with DR had increased arteriolar diameters[mean difference(MD):2.68,95%confidence interval(CI):0.64-4.72]and a higher risk of developing nailfold capillaroscopic abnormalities,including bushy capillaries[odds ratio(OR):2.82,95%CI:1.65-4.80],neoformation(OR:4.61,95%CI:3.15-6.76),megacapillaries(OR:8.37,95%CI:5.07-13.80),tortuosity(OR:7.29,95%CI:2.76-19.22),microhemorrhages(OR:6.16,95%CI:2.48-15.26),meandering capillaries(OR:4.68,95%CI:1.05-20.80)and avascular areas(OR:7.92,95%CI:2.68-23.38).The presence of tortuous capillary was more common in DR in India than in Turkey,while avascular area in the nailfolds was linked to DR only in India(OR:11.28,95%CI:3.91-32.60).Among the nailfold capillaroscopic abnormalities,tortuosity,microhemorrhage,and meandering capillary showed no significant correlation with the severity of DR,except for avascular area(P=0.04).CONCLUSION:There are significant associations between nailfold capillaroscopic findings and the presence of DR,supporting its potential as a non-invasive technique for monitoring microvascular changes in diabetic patients.However,further research is needed to validate its utility as an early screening tool for microvascular complications in diabetes.展开更多
AIM:To investigate the potential of optical coherence tomography angiography(OCTA)for detecting subclinical microvascular damage,possibly before ocular complications develop,in treatment-naive Cushing’s disease(CD)pa...AIM:To investigate the potential of optical coherence tomography angiography(OCTA)for detecting subclinical microvascular damage,possibly before ocular complications develop,in treatment-naive Cushing’s disease(CD)patients.METHODS:This retrospective cross-sectional study included 48 newly diagnosed,treatment-naive CD patients and 48 healthy controls.Ophthalmological examinations,including best-corrected visual acuity,intraocular pressure,optical coherence tomography(OCT),and OCTA were conducted.Retinal and choroidal vessel density(VD)parameters were assessed in the macular and peripapillary regions.Correlations between VD and systemic hormone levels were analyzed.RESULTS:Age(47.3±13.3y vs 43.4±15.8y;P=0.053)and gender distribution(CD:35 females,13 males;controls:34 females,14 males;P=1.000)did not significantly differ.Patient group exhibited significant reductions in radial peripapillary capillary(RPC;P<0.05)and choriocapillaris(CC)VD across all quadrants(P<0.05)compared to controls.Nasal deep capillary plexus(DCP)VD was also significantly decreased(P=0.035).Subfoveal choroidal thickness(SFCT;P=0.459)did not differ significantly,but nasal choroidal thickness(CT)at 1500μm(P<0.040)and 3000μm(P<0.031)was markedly increased.Notably,hormonal correlations revealed associations between ACTH and temporal CC VD(r=0.367,P=0.009),plasma cortisol and superior RPC VD(r=0.303,P=0.034),and urinary free cortisol with superior,and nasal RPC(r=-0.404,P=0.004,r=-0.317,P=0.027)and nasal DCP VD(r=-0.287,P=0.045).CONCLUSION:High endogenous cortisol levels in CD patients primarily affect the peripapillary region and the nasal part of the macula.VD changes occur before pachyvessel formation,choroidal thickening,and the development of pachychoroid spectrum disorder.展开更多
文摘BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.
基金Supported by University-Industry Collaborative Education Program of the Ministry of Education(No.231104794161945,No.230700562265543)Engineering Research Center of Integration and Application of Digital Learning Technology,Ministry of Education(No.1311016)+2 种基金Supply and Demand Job Matching and Student Development Program of Ministry of Education(No.2024011802142)Jiangsu Students’Platform for Innovation and Entrepreneurship Training Program(No.202410304127Y)the Science and Technology Project of Nantong City(No.MS2023050).
文摘AIM:To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy(DR)and compare findings in diabetic patients with and without DR.METHODS:PubMed,Web of Science,and Embase databases were searched from inception to February 2024.The quality of the included studies was evaluated using a National Institutes of Health(NIH)Quality Assessment tool for Observational Cohort and Cross Sectional Studies.Metaanalysis was conducted to compare the findings of nailfold capillaroscopy between diabetic patients with or without DR.Subgroup analysis was employed to investigate the source of heterogeneity.RESULTS:Totally 12 studies with 1349 diabetic patients were included,of which 628 had DR.The overall quality of included studies was acceptable.Patients with DR had increased arteriolar diameters[mean difference(MD):2.68,95%confidence interval(CI):0.64-4.72]and a higher risk of developing nailfold capillaroscopic abnormalities,including bushy capillaries[odds ratio(OR):2.82,95%CI:1.65-4.80],neoformation(OR:4.61,95%CI:3.15-6.76),megacapillaries(OR:8.37,95%CI:5.07-13.80),tortuosity(OR:7.29,95%CI:2.76-19.22),microhemorrhages(OR:6.16,95%CI:2.48-15.26),meandering capillaries(OR:4.68,95%CI:1.05-20.80)and avascular areas(OR:7.92,95%CI:2.68-23.38).The presence of tortuous capillary was more common in DR in India than in Turkey,while avascular area in the nailfolds was linked to DR only in India(OR:11.28,95%CI:3.91-32.60).Among the nailfold capillaroscopic abnormalities,tortuosity,microhemorrhage,and meandering capillary showed no significant correlation with the severity of DR,except for avascular area(P=0.04).CONCLUSION:There are significant associations between nailfold capillaroscopic findings and the presence of DR,supporting its potential as a non-invasive technique for monitoring microvascular changes in diabetic patients.However,further research is needed to validate its utility as an early screening tool for microvascular complications in diabetes.
文摘AIM:To investigate the potential of optical coherence tomography angiography(OCTA)for detecting subclinical microvascular damage,possibly before ocular complications develop,in treatment-naive Cushing’s disease(CD)patients.METHODS:This retrospective cross-sectional study included 48 newly diagnosed,treatment-naive CD patients and 48 healthy controls.Ophthalmological examinations,including best-corrected visual acuity,intraocular pressure,optical coherence tomography(OCT),and OCTA were conducted.Retinal and choroidal vessel density(VD)parameters were assessed in the macular and peripapillary regions.Correlations between VD and systemic hormone levels were analyzed.RESULTS:Age(47.3±13.3y vs 43.4±15.8y;P=0.053)and gender distribution(CD:35 females,13 males;controls:34 females,14 males;P=1.000)did not significantly differ.Patient group exhibited significant reductions in radial peripapillary capillary(RPC;P<0.05)and choriocapillaris(CC)VD across all quadrants(P<0.05)compared to controls.Nasal deep capillary plexus(DCP)VD was also significantly decreased(P=0.035).Subfoveal choroidal thickness(SFCT;P=0.459)did not differ significantly,but nasal choroidal thickness(CT)at 1500μm(P<0.040)and 3000μm(P<0.031)was markedly increased.Notably,hormonal correlations revealed associations between ACTH and temporal CC VD(r=0.367,P=0.009),plasma cortisol and superior RPC VD(r=0.303,P=0.034),and urinary free cortisol with superior,and nasal RPC(r=-0.404,P=0.004,r=-0.317,P=0.027)and nasal DCP VD(r=-0.287,P=0.045).CONCLUSION:High endogenous cortisol levels in CD patients primarily affect the peripapillary region and the nasal part of the macula.VD changes occur before pachyvessel formation,choroidal thickening,and the development of pachychoroid spectrum disorder.
