Retinal pathology in idiopathic moyamoya angiopathy detected by optical coherence tomography

Item Type:	Article
Title:	Retinal pathology in idiopathic moyamoya angiopathy detected by optical coherence tomography
Creators Name:	Albrecht, P. and Blasberg, C. and Lukas, S. and Ringelstein, M. and Müller, A.K. and Harmel, J. and Kadas, E.M. and Finis, D. and Guthoff, R. and Aktas, O. and Hartung, H.P. and Paul, F. and Brandt, A.U. and Berlit, P. and Methner, A. and Kraemer, M.
Abstract:	OBJECTIVE: To investigate whether patients with moyamoya angiopathy without obvious retinal pathologies such as retinal infarctions or the congenital morning glory anomaly may have subtle subclinical retinal changes. METHODS: In this cross-sectional study, spectral domain optical coherence tomography was used to analyze the retinal morphology of 25 patients with idiopathic moyamoya angiopathy and 25 age- and sex-matched healthy controls. We analyzed the retinal vasculature with blue laser autofluorescence, lipofuscin deposits with MultiColor confocal scanning laser ophthalmoscopy, and the optic nerve head (ONH) volume with a custom postprocessing algorithm. In addition to the total retinal thickness, semiautomated segmentation was used for segmentation of retinal layers in macular cross scans, macular volume scans, and peripapillary ring scans. RESULTS: The main finding was a pronounced reduction of the ONH volume in moyamoya angiopathy compared with controls (0.76 +/- 0.45 mm3 and 1.47 +/- 0.50 mm3, respectively; p < 0.0001), which was associated with a less pronounced reduction of the retinal nerve fiber layer in macular volume scans (0.97 +/- 0.11 mm3 and 1.10 +/- 0.10 mm3, respectively; p < 0.001). Autofluorescence and MultiColor confocal scanning laser ophthalmoscopy images revealed no pathologies except for one branch retinal artery occlusion. CONCLUSION: Our results indicate that even patients with moyamoya angiopathy who do not have obvious retinal abnormalities have retinal abnormalities. These can be detected by spectral domain optical coherence tomography, and the association of ONH abnormalities with the vascular changes may suggest that idiopathic moyamoya angiography is a systemic disease involving abnormalities of the early mesodermal development.
Keywords:	Cross-Sectional Studies, Moyamoya Disease, Nonparametric Statistics, Optic Disk, Optical Coherence Tomography, Regression Analysis, Retina, Retinal Diseases
Source:	Neurology
ISSN:	0028-3878
Publisher:	Lippincott Williams & Wilkins
Volume:	85
Number:	6
Page Range:	521-527
Date:	11 August 2015
Official Publication:	https://doi.org/10.1212/WNL.0000000000001832
PubMed:	View item in PubMed

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