Evaluation of macular and optic nerve head changes in young female patients with unilateral optic neuritis using optic coherence tomography angiography – two case reports

Abstract

Introduction Optic neuritis (ON) is described as an inflammation of the optic nerve which leads to the sudden loss of vision taking place over the course of several hours or days. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging tool which can be used for quantitative measurements of the microvascular changes in the retinochoroidal layers and optic nerve head.

Outlines of cases We present two case reports of Serbian patients with unilateral ON whose macular and optic nerve head parameters were observed using OCT-A up to six months following initial diagnosis and the administration of corticosteroid therapy. Patient 1 was a 23-year-old female with ON in her right eye. Patient 2 was also a 23-year-old female with ON in her right eye. Retinal nerve fiber layer thickness and the radial peripapillary capillary plexus density were significantly lower in the affected vs. healthy eyes in both whole image scan area and optic nerve head (p < 0.05). Central macular thickness was significantly lower in the affected vs. healthy eyes (p < 0.05). Both superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities in the fovea were significantly lower in the affected vs. healthy eyes (p < 0.05). SCP vessel density was also lower in the macula of the affected eyes (p < 0.05). Significant differences related to the size of foveal avascular zone and selected flow area were not found (p > 0.05).

Conclusion ON leaves permanent structural changes which can be detected using OCT-A even in patients with fully recovered visual acuity. Therefore, OCT-A should be included more in our daily clinical practice since it can provide useful data for the prognosis of various neuro-ophthalmological diseases and conditions.

Keywords: optic neuritis; OCT-A; optic nerve head; macula; RNFL; vessel density