Funda CERAN, Defne KALAYCI, Burcu POLAT GÜLTEKİN, Simten DAĞDAŞ, Neslihan BAYRAKTAR BİLEN, Mürüvet Sda AYDIN2, Gülsüm ÖZET

Polistemia Vera Hastalarında Optik Disk ve Makülanın Optik Koherans Tomografi Anjiyografi ile Değerlendirilmesi

Amaç: Bu çalışmanın amacı polistemia vera (PV) hastalarında optik disk ve maküla yapısı ile vasküler dansitenin optik koherans tomografi anjiyografi (OKT-A) ile değerlendirilmesi ve sağlıklı kontrollerle karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmada benzer yaş ve cinsiyette 12 PV hastasının 24 gözü ile 17 sağlıklı katılımcının 34 gözü karşılaştırılmıştır. Optik diski içine alan 4.5 mm X 4.5 mm’lik ve makülayı içine alan 6 mm X 6mm’lik alandan AngioVue ile OKT-A görüntüleri alındı. Retinal sinir lifi tabakası (RSLT) kalınlığı; radyal peripapiller kapiller damar dansitesi; santral makula kalınlığı; maküler yüzeyel, derin ve koryokapiller pleksus damar dansitesi, foveal avasküler zon ve asirkülarite indeksi ölçümleri karşılaştırıldı. Bulgular: PV hastalarında RSLT superior ve temporalde kontrol grubuna göre anlamlı derecede düşüktü (sırası ile 126.83± 16.76 & 138.94± 14.02 p= 0.004; 69.62± 10.15 &76.94 ±10.15 p =0.009). Peripapiller kapiller damar dansitesi tüm görüntüde, peripapiller ve superior peripapiller alanda PV’da anlamlı derecede düşüktü (48.50± 2.80 & 49.86 ± 2.18 p =0.042; 51.85± 2.98 & 53.22± 2.24 p =0.00; 51.69± 2.88 & 53.48± 2.55 p =0.016). Makülada yüzeyel vasküler pleksus damar yoğunluğu tüm görüntüde,parafoveada ve perifoveada PV’da anlamlı olarak düşüktü (45.27 ±2.73 & 47.34±3.01 p =0.014; 45.76± 3.87 & 48.16±4.14 p =0.037; 45.84±2.76 & 48.06±3.09 p =0.008). Koryokapiller damar dansitesi parafoveada, PV’da anlamlı olarak yüksekti (67.48±3.16 & 65.29±4.23 p =0.034). Sonuç: PV hastalarında superior ve temporal retina sinir lifi tabakasında incelme; bazı alanlarda peripapiller ve yüzeyel maküler damar yoğunluğunda azalma, koryokapiller damar yoğunluğunda artma olmaktadır. Bu durum PV’da artmış kan vizkozitesi ve gecikmiş kan akımı ile açıklanabilir.

Assessment of Optic Disc and Macula of Polycythemia Vera Patients by Optical Coherence Tomography Angiography

Objective: The aim of this study is to assess the ultrastructure and vascular density of the optic disc and macula by optical coherence tomography angiography (OCT-A) in patients with Polycythemia Vera (PV) and to compare with healthy controls. Material and Method: Twenty-four eyes of 12 PV patients and 34 eyes of 17 healthy subjects with similar age and sex were recruited in this study. AngioVue OCT-A images were taken in an area of 4.5 X 4.5 mm for optic disc and 6X6 mm for macula. Retinal nerve fiber layer (RNFL) thickness, radial peripapillary capillary vessel density, central macular thickness, macular capillary plexus vascular densities, foveal avascular zone, acircularity index were measured. Results: RNFL thickness in the superior and temporal area were significantly thinner in PV patients than in controls (respectively 126.83± 16.76 & 138.94± 14.02 p =0.004; 69.62± 10.15 &76.94 ±10.15 p =0.009). Peripapillary capillary vessel density in whole image, peripapillary and superior peripapillary region were significantly reduced in PV patients (48.50± 2.80 & 49.86 ± 2.18 p =0.042; 51.85± 2.98 & 53.22± 2.24 p =0.050; 51.69± 2.88 & 53.48± 2.55 p =0.016). Superficial macular vessel density were significantly reduced in whole image, parafoveal and perifoveal regions in PV patients (45.27 ±2.73 & 47.34±3.01 p= 0.014; 45.76± 3.87 &48.16±4.14 p =0.037; 45.84±2.76 & 48.06±3.09 p =0.008). Parafoveal choriocapillary vessel density was significantly increased in PV patients (67.48±3.16 & 65.29±4.23 p =0.034). Conclusion: RNFL thickness decreases, peripapillary and macular vessel density decreases and choriocapillary vessel density increases in PV patients. This can be related to increased blood viscosity and delayed blood flow.

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