Optical coherent tomography - angiography at atrophy of the visual nerve with multiple sclerosis
The purpose of the study is to assess the state of microcirculation of the optic nerve disk of the peripapillary retina in patients with optic atrophy (OA) with multiple sclerosis without a history of optical neuritis (MS-ON). Material and Methods. We examined 34 eyes of patients with OA with MS-ON and 39 eyes of healthy volunteers comparable in gender and age. In addition to standard ophthalmological examination, all patients underwent optical coherence tomography with the function of angiography (OCT-A) of the optic nerve head (ONH) with the measurement of thickness of the peripapillary retina and the relative density of capillaries, as well as the measurement of thickness of the complex of retinal ganglion cells (GCC). To assess the diagnostic value of OKT-A, a ROC-analysis was performed using the most informative predictors. Results. According to the results of OCT-A in patients with MS-ON, the most pronounced differences in the indicators were revealed for all indicators of the thickness of the peripapillary layer of the retinal nerve fibers (RNFL) and the relative density of the retinal peripapillary capillaries (RPC) in all sectors compared with the control group, as well as a decrease in the average indicators in the complex of retinal ganglion cells (GCC). A moderate direct correlation was found between the thicknesses of the peripapillary RNFL and the density of the RPC (r = 0.50; p < 0.05), as well as with the average GCC values (r=0.69; p< 0.05). Conclusion. In patients with optic atrophy against the background of multiple sclerosis without optical neuritis in the anamnesis with the help of OCT-A, we detected a significant decrease in the RNFL thickness and RPC density, compared to the norm, which indicates a deterioration in the microcirculation of the peripapillary retina associated with the process of neurodegeneration.