Microvascular Breakdown Due to Retinal Neurodegeneration in Ataxias.

ataxia optical coherence tomography angiography retinal ganglion cells retinal superficial vascular complex retinal vessel density

Journal

Movement disorders : official journal of the Movement Disorder Society
ISSN: 1531-8257
Titre abrégé: Mov Disord
Pays: United States
ID NLM: 8610688

Informations de publication

Date de publication:
01 2022
Historique:
revised: 09 08 2021
received: 26 05 2021
accepted: 26 08 2021
pubmed: 18 9 2021
medline: 17 3 2022
entrez: 17 9 2021
Statut: ppublish

Résumé

Neurodegenerative ataxias are devastating disorders of the cerebellum and spinal cord, accompanied by death of retinal ganglion cells, leading to relentlessly progressive decline of motor coordination and permanent disability. Retinal microvascular affection has not yet been determined. The aim of this study is to assess whether retinal microvascular alterations occur and, if so, whether they are concurrent with or follow cell death in the retina in neurodegenerative diseases. This study involves the cross-sectional observational study of 43 patients with ataxia and 43 controls enrolled from August 1, 2018, to September 30, 2020. The extent of ataxia was determined by the Scale for the Assessment and Rating of Ataxia. Changes in retinal vasculature were examined by optical coherence tomography angiography (OCT-A) and retinal cell and fiber density by OCT in ataxias concurrently. When comparing the ataxia cohort with healthy subjects, ataxia patients exhibited reduced vessel density in the radial peripapillary capillary (RPC) network (P = 0.005), capillary density inside the optic nerve head (cdONH) (P < 0.001), nasal superficial vascular plexus (P = 0.03) as well as reduced ganglion cell layer (GCL) volume (P = 0.04), and temporal peripapillary retinal nerve fiber layer thickness (P = 0.04). Mixed effect analysis modeling laterality confirmed these findings. These findings demonstrate a distinct pattern of concurrent changes in vessel density of the retinal superficial vascular complex, encompassing the superficial vascular plexus, RPC network and cdONH, and retinal GCL volume, providing new insights into the ongoing degeneration in ataxias. Our findings may have relevance for design of novel therapeutic approaches for ataxias and possibly other neurodegenerative diseases.

Sections du résumé

BACKGROUND
Neurodegenerative ataxias are devastating disorders of the cerebellum and spinal cord, accompanied by death of retinal ganglion cells, leading to relentlessly progressive decline of motor coordination and permanent disability. Retinal microvascular affection has not yet been determined.
OBJECTIVES
The aim of this study is to assess whether retinal microvascular alterations occur and, if so, whether they are concurrent with or follow cell death in the retina in neurodegenerative diseases.
METHODS
This study involves the cross-sectional observational study of 43 patients with ataxia and 43 controls enrolled from August 1, 2018, to September 30, 2020. The extent of ataxia was determined by the Scale for the Assessment and Rating of Ataxia. Changes in retinal vasculature were examined by optical coherence tomography angiography (OCT-A) and retinal cell and fiber density by OCT in ataxias concurrently.
RESULTS
When comparing the ataxia cohort with healthy subjects, ataxia patients exhibited reduced vessel density in the radial peripapillary capillary (RPC) network (P = 0.005), capillary density inside the optic nerve head (cdONH) (P < 0.001), nasal superficial vascular plexus (P = 0.03) as well as reduced ganglion cell layer (GCL) volume (P = 0.04), and temporal peripapillary retinal nerve fiber layer thickness (P = 0.04). Mixed effect analysis modeling laterality confirmed these findings.
CONCLUSIONS
These findings demonstrate a distinct pattern of concurrent changes in vessel density of the retinal superficial vascular complex, encompassing the superficial vascular plexus, RPC network and cdONH, and retinal GCL volume, providing new insights into the ongoing degeneration in ataxias. Our findings may have relevance for design of novel therapeutic approaches for ataxias and possibly other neurodegenerative diseases.

Identifiants

pubmed: 34533237
doi: 10.1002/mds.28791
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

162-170

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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Auteurs

Christopher A Turski (CA)

Department of Ophthalmology, University of Bonn, Bonn, Germany.
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.

Gabrielle N Turski (GN)

Department of Ophthalmology, University of Bonn, Bonn, Germany.
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.

Jennifer Faber (J)

German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Department of Neurology, University of Bonn, Bonn, Germany.

Stefan J Teipel (SJ)

Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.
German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.

Frank G Holz (FG)

Department of Ophthalmology, University of Bonn, Bonn, Germany.

Thomas Klockgether (T)

German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Department of Neurology, University of Bonn, Bonn, Germany.

Robert P Finger (RP)

Department of Ophthalmology, University of Bonn, Bonn, Germany.

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