Mahatme C, Kaushik M, Saravanan VR, Kumar K, Shah VM. Macular microvascular and structural changes on optical coherence tomography angiography in atypical optic neuritis. World J Methodol 2025; 15(1): 98482 [DOI: 10.5662/wjm.v15.i1.98482]
Corresponding Author of This Article
Virna M Shah, DO, Chief Physician, Department of Neuro-ophthalmology, Aravind Eye Hospital, Tamilnadu, Coimbatore 641014, India. virna@aravind.org
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Methodol. Mar 20, 2025; 15(1): 98482 Published online Mar 20, 2025. doi: 10.5662/wjm.v15.i1.98482
Macular microvascular and structural changes on optical coherence tomography angiography in atypical optic neuritis
Chinmay Mahatme, Madhurima Kaushik, Veerappan Rathinasabapathy Saravanan, Karthik Kumar, Virna M Shah
Chinmay Mahatme, Department of General Ophthalmology, Aravind Eye Hospital, Coimbatore 641014, Tamil Nādu, India
Madhurima Kaushik, Karthik Kumar, Virna M Shah, Department of Neuro-ophthalmology, Aravind Eye Hospital, Coimbatore 641014, Tamil Nādu, India
Veerappan Rathinasabapathy Saravanan, Department of Vitreoretina, Aravind Eye Hospital, Coimbatore 641014, Tamil Nādu, India
Author contributions: Kaushik M and Kumar K conducted the study; Shah VM and Saravanan VR designed the study; Mahatme C analyzed the data and wrote the paper; Shah VM supervised the study.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Aravind Eye Hospital, Madurai, India.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to use of anonymous patient data for research at the time of registration in the outpatient department. We applied the opt-out method to obtain consent for this study by using a poster.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at virna@aravind.org.
STROBE statement: The authors have read the STROBE Statement—checklist of items—and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Virna M Shah, DO, Chief Physician, Department of Neuro-ophthalmology, Aravind Eye Hospital, Tamilnadu, Coimbatore 641014, India. virna@aravind.org
Received: June 27, 2024 Revised: August 1, 2024 Accepted: August 13, 2024 Published online: March 20, 2025 Processing time: 94 Days and 3.5 Hours
Abstract
BACKGROUND
Atypical optic neuritis, consisting of neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein antibody disease (MOGAD), has a very similar presentation but different prognostic implications and long-term management strategies. Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders, apart from the obvious immune mediated damage. With the advent of optical coherence tomography angiography (OCTA), it is easy to pick up on these subclinical macular microvascular and structural changes.
AIM
To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.
METHODS
This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients, diagnosed serologically, as well as 10 healthy controls. Macular vascular density (MVD) and ganglion cell + inner plexiform layer thickness (GCIPL) were studied using OCTA.
RESULTS
There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls. NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls. NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes. On comparing NMOSD with MOGAD, there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.
CONCLUSION
Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients, they could not help in differentiating between NMOSD and MOGAD cases.
Core Tip: Our observational study shows that although there are microvascular and structural changes seen on optical coherence tomography angiography in atypical optic neuritis, these changes could not help in differentiating between neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody disorder cases.
