Cytomegalovirus-positive Posner-Schlossman syndrome: to compare differences in retinal vessel area density between the affected and non-affected eye using optical coherence tomography angiography,Graefe's Archive for Clinical and Experimental Ophthalmology

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Cytomegalovirus-positive Posner-Schlossman syndrome: to compare differences in retinal vessel area density between the affected and non-affected eye using optical coherence tomography angiography
Graefe's Archive for Clinical and Experimental Ophthalmology ( IF 2.4 ) Pub Date : 2023-07-22 , DOI: 10.1007/s00417-023-06171-5
Patricia Hülse ₁ , Emanuel Reitemeyer ₁ , Anne Rübsam ₁ , Uwe Pleyer ₁ , Anna-Karina B Maier ₁

Affiliation

Purpose

To analyse differences in the retinal microvasculature in eyes with cytomegalovirus (CMV)-positive Posner-Schlossman syndrome (PSS) compared to the non-affected eyes using optical coherence tomography angiography (OCTA).

Methods

In this monocentric, observational prospective case series, 25 patients with unilateral CMV-positive PSS were included. We compared the vessel area densities (VAD) in the macula, optic disc, and peripapillary region in PSS-affected and non-affected eyes using OCTA. We compared the visual fields (VF) of the affected and healthy eyes of each patient. The mean deviation (MD) of the VF was analysed together with the retinal nerve fibre layer (RNFL) thickness to evaluate the strength of correlation with the VAD parameters.

Results

The VAD of the peripapillary superficial vascular complex (SVC) is significantly reduced in CMV-positive PSS-affected eyes (46.1 ± 9.3% versus 50.1 ± 6.3%, p = 0.008, adjusted p = 0.048). The VAD of the deeper macular, papillary, and peripapillary layers showed no differences between the affected and non-affected eyes. The mean deviation and the retinal nerve fibre layer thickness had correlations with the VAD of the macula (r = 0.451, p = 0.001, r = 0.553, p < 0.001), the peripapillary SCV (r = 0.430, p = 0.002, r = 0.723, p < 0.001), and the papillary region (r = 0.512, p < 0.001, r = 0.292, p = 0.039). Patients receiving systemic antiviral therapy (SAT) showed better VAD of the peripapillary choriocapillary layer (p = 0.001, no therapy: 31.4 ± 1.9%, SAT: 35.0 ± 1.6%), and choroidal layer (p = 0.009, no therapy: 34.2 ± 0.3%, SAT: 36.3 ± 1.8%) compared to those with no SAT.

Conclusion

A lower peripapillary VAD in the SVC might indicate vascular dysfunction as a sign of glaucomatous damage. SAT might have positive effects on the microcirculation in the deep retinal and choroidal layers.

Trial registration

TRN: DRKS00028266, https://www.drks.de/drks_web/.

中文翻译：

巨细胞病毒阳性波斯纳-施洛斯曼综合征：使用光学相干断层扫描血管造影术比较受影响和未受影响的眼睛之间视网膜血管面积密度的差异

目的

使用光学相干断层扫描血管造影 (OCTA) 分析巨细胞病毒 (CMV) 阳性波斯纳-施洛斯曼综合征 (PSS) 眼睛与未受影响眼睛的视网膜微血管系统的差异。

方法

在这个单中心、观察性前瞻性病例系列中，纳入了 25 名单侧 CMV 阳性 PSS 患者。我们使用 OCTA 比较了 PSS 受影响和未受影响的眼睛的黄斑、视盘和视乳头周围区域的血管面积密度 (VAD)。我们比较了每位患者受影响眼睛和健康眼睛的视野 (VF)。将 VF 的平均偏差 (MD) 与视网膜神经纤维层 (RNFL) 厚度一起分析，以评估与 VAD 参数的相关强度。

结果

在受 CMV 阳性 PSS 影响的眼睛中，视乳头周围浅层血管复合体 (SVC) 的 VAD 显着降低（46.1 ± 9.3% 对比 50.1 ± 6.3%，p = 0.008，调整后的 p = 0.048 ）。较深的黄斑层、乳头层和乳头周围层的 VAD 显示受影响的眼睛和未受影响的眼睛之间没有差异。平均偏差和视网膜神经纤维层厚度与黄斑 VAD ( r = 0.451, p = 0.001, r = 0.553, p < 0.001)、视盘周围 SCV ( r = 0.430, p = 0.002, r = 0.723，p < 0.001）和乳头状区域（r = 0.512，p < 0.001，r = 0.292，p = 0.039）。接受全身抗病毒治疗 (SAT) 的患者表现出更好的视乳头周围脉络膜毛细血管层 VAD（p = 0.001，无治疗：31.4 ± 1.9%，SAT：35.0 ± 1.6%）和脉络膜层（p = 0.009，无治疗：34.2 ± 0.3%，SAT：36.3 ± 1.8%）与没有 SAT 的人相比。