Combining paracentral acute middle maculopathy and peripapillary fluid as biomarkers in anterior ischemic optic neuropathy: OCT biomarkers in anterior ischemic optic neuropathy.
Oliver Niels Klefter, Michael Stormly Hansen, Lea Lykkebirk, Yousif Subhi, Jane Maestri Brittain, Mads Radmer Jensen, Uffe Møller Døhn, Viktoria Fana, Anne Katrine Wiencke, Steffen Heegaard, Lene Terslev, Steffen Hamann
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引用次数: 0
Abstract
Purpose: To determine if paracentral acute middle maculopathy (PAMM) and peripapillary intraretinal and subretinal fluid (IRF/SRF) could help distinguish between arteritic anterior ischemic optic neuropathy (A-AION) and non-arteritic AION (NA-AION) at an early stage.
Methods: This study used single-center optical coherence tomography (OCT) data from 8 patients with A-AION and 24 patients with NA-AION from two prospective cross-sectional studies with consecutive sampling (ClinicalTrials.gov: NCT05248906 and NCT05305079). The diagnosis of A-AION was based on expert interpretation of biochemical markers of inflammation, temporal artery biopsy and positron emission tomography/computed tomography. The diagnosis of NA-AION was made in cases without suspicion or clinical evidence of A-AION and with confirmed neuroophthalmological expert diagnosis. For this substudy patients were also required to have an OCT scan in relation to the diagnosis of AION. Macular OCT scans were graded by two independent, masked graders for the presence of PAMM and for IRF/SRF. The extension of IRF/SRF was assessed using an Early Treatment Diabetic Retinopathy Study (ETDRS) grid.
Results: PAMM was found in 50% of patients with A-AION and in 0% of patients with NA-AION (P = 0.0019). In the setting of AION, the sensitivity of PAMM for the diagnosis of A-AION was 50% (95%CI: 16 to 84%) while the specificity was 100% (95%CI: 86 to 100%). Conversely, peripapillary IRF/SRF with extension into the ETDRS grid was observed in 83% of patients with NA-AION but in 0% of patients with A-AION (P =0.000047). The sensitivity of central macula-involving IRF/SRF for the diagnosis of NA-AION was 83% (95%CI: 63 to 95%), while the specificity was 100% (95%CI: 63 to 100%). Combining the two biomarkers, 75% of patients with AION could be classified based on OCT alone.
Conclusion: PAMM appears to be a biomarker of A-AION while extensive peripapillary fluid appears to be a biomarker of NA-AION. Combining OCT biomarkers might allow for early classification of AION and warrants further prospective studies.
期刊介绍：
The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect.
The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports.
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