Structural and Microvascular Changes in Demyelinating Optic Neuritis Assessed by OCT and OCTA: A 6-Month Longitudinal...

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Demyelinating optic neuritis (DON) is an inflammatory condition affecting the optic nerve.
• Understanding the longitudinal structural and vascular changes in DON is crucial for patient management.

Purpose of the Study:

• To longitudinally characterize structural and vascular density changes in demyelinating optic neuritis (DON) using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA).

Main Methods:

• Prospective study of 23 patients with first unilateral DON.
• Assessments included visual acuity, retinal nerve fiber layer (pRNFL), ganglion cell complex (GCC), focal loss volume (FLV), global loss volume (GLV), and vessel densities (OCTA) at baseline and 6 months.
• Statistical analysis included Wilcoxon test with Benjamini-Hochberg correction.

Main Results:

• Affected eyes initially showed increased pRNFL thickness, followed by significant thinning at 6 months and longitudinally.
• Progressive neuroaxonal loss (FLV, GLV) occurred in affected eyes, while fellow eyes remained stable.
• OCTA revealed reduced peripapillary vessel density at 6 months, with subtle microvascular alterations.

Conclusions:

• DON has a dynamic course with early thickening and subsequent progressive neuroaxonal loss.
• Longitudinal OCT and OCTA findings indicate sustained axonal degeneration and parallel microvascular changes.
• OCT and OCTA provide complementary insights for monitoring demyelinating optic neuropathies.