Low peripapillary vascular density increases optic disc drusen volume

A new study by Lykkebirk and team showed that areas adjacent to the optic disc have a decreased density of blood vessels, and there is a reciprocal relationship between the optic disc drusen (ODD) and the density of blood vessels in the surrounding peripapillary region. The findings of this study were published in the Journal of Neuro-Ophthalmology.

Acellular calcified deposits known as optic disc drusen are found inside the optic nerve head and are known to induce visual field abnormalities. Optical coherence tomography (EDI-OCT) with increased depth imaging is a new gold standard for diagnosing ODD. OCT angiography (OCTA) can be used to see how ODD impacts the peripapillary vasculature that is nearby. Using a newly created multimodal OCT technique, this study examines the relationship between peripapillary vessel density and anatomical ODD position and volume.

a case-control study involving 24 healthy controls and 16 individuals with ODD who were diagnosed between 2008 and 2017. Data on EDI-OCT, OCTA, and demographics were gathered for all patients and controls. Patient ODD was visualized in three dimensions (3D) using EDI-OCT and the medical imaging segmentation program ITK-SNAP. It was feasible to link ODD volume to the peripapillary vascular density in the relevant modified Garway-Heath segments of the optic disc by superimposing ODD 3D visualization and associated OCTA images.

The key findings of this study were:

The mean peripapillary vascular density was found to be lower in ODD patients than in controls throughout all modified Garway-Heath segments, with a significant decrease in peripapillary vessel density in the superior segment (P = 0.03) and worldwide (P = 0.05).

In the adjacent section, a strong negative relationship between ODD volume and peripapillary vascular density was seen (P = 0.002).

This study clearly emphasizes the role of peripapillary vascular density in terms of assessing individuals for ODD. It states the clinical importance of peripapillary vascular density and how it is a very good diagnostic tool.

Reference: 

Lykkebirk, L., Wessel Lindberg, A.-S., Karlesand, I., Heiberg, M., Malmqvist, L., & Hamann, S. (2022). Peripapillary Vessel Density in Relation to Optic Disc Drusen: A Multimodal Optical Coherence Tomography Study. In Journal of Neuro-Ophthalmology (Vol. 43, Issue 2, pp. 185–190). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/wno.0000000000001667