Study of peripapillary vascular flow using optical coherence tomography angiography in optic nerve head drusen.

IMPORTANCE: To evaluate peripapillary vascular flow using optical coherence tomography angiography (angio-OCT) in patients with optic nerve head drusen (ONHD). BACKGROUND: Angio-OCT allows non-invasive visualization and quantification peripapillary vascular flow. DESIGN: Cross-sectional study. PARTICIPANTS: Seventy-six eyes of 40 patients. METHODS: Between January 2018 and May 2019, consecutive patients with ONHD and healthy controls underwent a complete ocular assessment, including visual acuity testing, biomicroscopy, tonometry, funduscopy, automated perimetry, retinography and autofluorescence, spectral-domain OCT, and peripapillary angio-OCT. MAIN OUTCOMES MEASURES: Peripapillary vascular flow, vascular density, retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thicknesses. RESULTS: We included 23 patients with ONHD (42 eyes, 32 with visible drusen) (mean age 50.96 years, 12 men) and 17 control patients (34 eyes) (mean age 47.12 years, 7 men), without significant differences in age or sex. Vascular flow and density were significantly lower in patients with ONHD (0.409 and 40.18%, respectively) than in normal eyes (0.438 and 43.30%, respectively) (P = 0.006 and P < 0.001). RNFL and GCL thicknesses were significantly lower in patients with ONHD (81.81 μm and 77.43 μm, respectively) than in controls (91.38 μm and 81.97 μm, respectively) (P = 0.001 and P = 0.032). We obtained high correlation indexes between RNFL and GCL and vascular flow and density (RNFL = 0.702 and 0.744, respectively, and GCL = 0.808 and 0.857, respectively). CONCLUSIONS AND RELEVANCE: Angio-OCT demonstrated significant reductions in peripapillary vascular flow and vascular density in patients with ONHD, with strong correlations with RNFL and GCL thicknesses. This article is protected by copyright. All rights reserved.