Clinical trial NCT03642899: OCT Angiography in Arteritic and Non Arteritic Anterior Ischemic Neuropathy
Official title: Study of Peripapillary Vasculature With OCT-angiography in Arteritic and Non Arteritic Anterior Ischemic Neuropathy After Oedema Disappearance
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Neuropathy, Optic
Lead sponsor: Poitiers University Hospital
Sponsor class: OTHER
First posted: 2018-08-22
Enrollment: 17
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: * Patients with arteritic or non-arteritic anterior ischemic optic neuropathy ,\> 3 months or after disappearance of papillary edema
* Control subjects, with normal optic nerve and symmetrical appearance

Brief summary: Anterior ischaemic optic neuropathy results from infarction of retrolaminar portion of the optic nerve head, caused by occlusion of the posterior ciliary artery. Non arteritic anterior ischaemic optic neuropathy affects more frequently people between 50 and 70 years of age, with vasculopathic risk factors. Arteritic anterior ischaemic optic neuropathy is caused by the Horton disease, affects an older population and is an ophthalmologic emergency because of the bilateralisation's risk.

The aim of this study is to compare the peripapillar vascular density of anterior ischaemic optic neuropathy eyes (arteritic and non arteritic) with normal eyes after the disappearance of the papillar edema, with oCT-angiography.

The investigators will include patients with anterior ischaemic optic neuropathy and normal patients. For each participant, the investigators will estimate the best visual acuity, intra-ocular pressure, make a fondus, measurement of retinal nervous layer thickness, ganglionar cells layer thickness, and a macular and papillar OCT angiography during a consultation (duration 30 min).

The investigators will be able to know if

* there is a modification of the peripapillary vascularisation subsequent to the occlusion of the posterior ciliary artery
* there is a difference between arteritic and non arteritic anterior ischaemic optic neuropathy,
* there is a repercussion of the neuropathy on the retinal layers,
* there is a difference in peripapillar vascularisation by age.

Detailed description: Anterior ischaemic optic neuropathy results from infarction of retrolaminar portion of the optic nerve head, caused by occlusion of the posterior ciliary artery. Non arteritic anterior ischaemic optic neuropathy affects more frequently people between 50 and 70 years of age, with vasculopathic risk factors. Arteritic anterior ischaemic optic neuropathy is caused by the Horton disease, affects an older population and is an ophthalmologic emergency because of the bilateralisation's risk.

The aim of this study is to compare the peripapillar vascular density of anterior ischaemic optic neuropathy eyes (arteritic and non arteritic) with normal eyes after the disappearance of the papillar edema, with oCT-angiography.

The investigators will include patients with anterior ischaemic optic neuropathy and normal patients. For each participant, the investigators will estimate the best visual acuity, intra-ocular pressure, make a fondus, measurement of retinal nervous layer thickness, ganglionar cells layer thickness, and a macular and papillar OCT angiography during a consultation (duration 30 min).

The investigators will be able to know if

* there is a modification of the peripapillary vascularisation subsequent to the occlusion of the posterior ciliary artery
* there is a difference between arteritic and non arteritic anterior ischaemic optic neuropathy,
* there is a repercussion of the neuropathy on the retinal layers,
* there is a difference in peripapillar vascularisation by age.

Eligibility criteria: Inclusion Criteria:

* Patients with arteritic or non-arteritic anterior ischemic optic neuropathy ,\> 3 months or after disappearance of papillary edema
* Control subjects, with normal optic nerve and symmetrical appearance , without diagnosed glaucoma (intraocular tension lower than 21mmHg) and without antecedent of retinal or intraorbital pathology.
* Patient with cataract can be included, within the limits of the good acquisition of images.
* Free, without tutorship or curatorship or subordination
* Benefiting from a Social Security scheme or benefiting through a third party
* Giving their non-opposition, after clear and fair information on the study

Exclusion Criteria:

* with ocular or retinal pathology leading to irreversible visual impairment or macular involvement (strong myopia\> 6 diopters, astigmatism\> 3 diopters, retinitis pigmentosa, occlusion of the central artery of the retina or central vein of the retina , CRSC, diabetic retinopathy), or history of ocular or retinal surgery except cataract surgery.
* having an alteration of the optic nerve related to another pathology (NORB, glaucoma evolved with cup / disc\> 0.7 or poorly balanced tension, optic neuritis),
* performing the exam impossible or poor image quality
* impossibility of giving one's non-opposition,
* not benefiting from a social security scheme or benefiting from it through a third person
* benefiting from enhanced protection, namely: minors, persons deprived of their liberty by a judicial or administrative decision, persons staying in a health or social institution, adults under legal protection.

Primary outcomes:
measure: compare peripapillary vascular density in eyes with anterior ischaemic optic neuropathy and in normal eyes with OCT angiography
timeFrame: 10 minutes
Secondary outcomes:
measure: compare vascular microvascular density at the macular level with angio-OCT in patients with anterior ischemic optic neuropathy and control subjects
timeFrame: 10 minutes
measure: Compare Peripapillary and Macular Mirovascular Differences in Arteritic and Non-Arteritic anterior ischemic optic neuropathy Patients
timeFrame: 10 minutes
measure: compare the microvascular density of the 2 optic discs in the same patient : with optic neuropathy and the healthy disc
timeFrame: 10 minutes
measure: compare the thickness of the peripapillary retinal nerve fibers and the thickness of the ganglionar complex layer in patients with anterior ischemic optic neuropathy and control group
timeFrame: 5 minutes
measure: Compare peripapillary and macular microvascular density by age and by sex
timeFrame: 10 minutes
Other outcomes:
Locations:
city: Poitiers
country: France
facility: CHU Poitiers
Study officials:
References:
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citation: Liu CH, Kao LY, Sun MH, Wu WC, Chen HS. Retinal Vessel Density in Optical Coherence Tomography Angiography in Optic Atrophy after Nonarteritic Anterior Ischemic Optic Neuropathy. J Ophthalmol. 2017;2017:9632647. doi: 10.1155/2017/9632647. Epub 2017 Feb 19.
citation: Moghimi S, Afzali M, Akbari M, Ebrahimi KB, Khodabande A, Yazdani-Abyaneh AR, Ghafouri SNH, Coh P, Okhravi S, Fard MA. Crowded optic nerve head evaluation with optical coherence tomography in anterior ischemic optic neuropathy. Eye (Lond). 2017 Aug;31(8):1191-1198. doi: 10.1038/eye.2017.56. Epub 2017 Apr 7.
citation: Sharma S, Ang M, Najjar RP, Sng C, Cheung CY, Rukmini AV, Schmetterer L, Milea D. Optical coherence tomography angiography in acute non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol. 2017 Aug;101(8):1045-1051. doi: 10.1136/bjophthalmol-2016-309245. Epub 2017 Jan 5.
citation: Song Y, Min JY, Mao L, Gong YY. Microvasculature dropout detected by the optical coherence tomography angiography in nonarteritic anterior ischemic optic neuropathy. Lasers Surg Med. 2018 Mar;50(3):194-201. doi: 10.1002/lsm.22712. Epub 2017 Oct 7.