Quantitative vessel density around foveal avascular zone as a potential imaging biomarker for detecting central nervous system injury in Wilson's disease: an optical coherence tomography angiography study

以黄斑无血管区周围定量血管密度作为检测威尔逊病中枢神经系统损伤的潜在影像学生物标志物:一项光学相干断层扫描血管成像研究

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Abstract

BACKGROUND: Studies have confirmed that optical coherence tomography angiography (OCTA) can detect early retinal microvascular impairment in many diseases. However, as far as we know, only one study has found retinal and optic disc microcirculation changes in Wilson's disease (WD) by OCTA. The purpose of our study was to evaluate the OCTA parameters in WD. METHODS: We performed a cross-sectional study at the First Affiliated Hospital of Guangdong Pharmaceutical University between June 2021 and April 2022. A total of 42 WD patients and 40 gender- and age-matched healthy controls (HEC) were recruited in this study. WD patients were divided into neurological form (NWD) and hepatic form (HWD) of the disease. All participants underwent retinal OCTA to assess the superficial vessel density (VD), deep VD, and foveal avascular zone (FAZ) parameters. The FAZ parameters included the area in mm(2), perimeter in mm, and VD of the 300 µm-width annulus surrounding FAZ (FD-300). Statistical tests used in this study included Chi-squared test, one-way analysis, correlation analysis, and t-test or Mann-Whitney U test. RESULTS: WD patients comprised 21 females and 21 males, with mean age of 30.54±9.83 years. HEC comprised 16 females and 24 males, with mean age of 30.42±7.37 years. NWD had smaller FD-300 (51.67%±5.29% vs. 55.87%±3.85%, P<0.01) than HEC and smaller FD-300 (51.67%±5.29% vs. 55.42%±4.09%, P<0.05) than HWD. There was no significant difference in OCTA parameters between HWD and HEC. CONCLUSIONS: Our study indicated that OCTA may be a useful tool for detecting central nervous system (CNS) injury in WD. We speculate that the decrease of FD-300 may be a sign of CNS injury in WD.

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