Parafoveal and optic disc vessel density in patients with obstructive sleep apnea syndrome: an optical coherence tomography angiography study.

AIMS: To compare optic disc perfusion, radial peripapillary capillaries (RPC) and macular vascular density, between normal subjects and subjects with obstructive sleep apnea syndrome (OSAS) using spectral-domain OCT angiography (OCTA). METHODS: Sixteen eyes of patients with mild OSAS, 17 eyes with moderate OSAS, 20 eyes with severe OSAS on polygraphy and 28 controls were evaluated with OCTA RT XR Avanti (AngioVue software, Optovue Inc., Fremont, CA). Optic nerve head (ONH), RPC and macular vessel density were measured. Clinical data, visual field parameters, and Spectral Domain OCT evaluation (retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness) were recorded for all patients. RESULTS: ONH vascular flow (p = 0,396), RPC vascular density (automatized data "whole" p = 0,913, "peripapillary" p = 0,539, and segmented analysis with a topographic grid) and macular vascular density (foveal p = 0,484, parafoveal p = 0,491) were not significantly different between the four groups. FDT-Matrix™ and Humphrey 24/2 mean deviation were significantly lower in eyes with severe OSAS and were correlated to the apnea-hypopnea index. Retinal nerve fiber layer (RNFL) thickness, Cup/Disc ratio, rim area, and ganglion cell complex (GCC) were not significantly modified. CONCLUSIONS: OCTA did not detect reduced ONH, RPC, neither macular blood vessel density in eyes with OSAS. The precise mechanisms that link OSAS with optic nerve pathologies remain unclear: our study was not able to demonstrate a vascular impact by OCTA examination.

DIFFUSE LARGE B-CELL LYMPHOMA-ASSOCIATED-RETINOPATHY CHARACTERIZED BY MINIMAL MORPHOLOGIC CHANGES AND SEVERE FUNCTIONAL IMPAIRMENT.

PURPOSE: To report the case of a patient whose retinal disease was found to be associated with a diffuse large B-cell lymphoma found 30 years after the apparent successful treatment of a classical Hodgkin lymphoma. METHODS: Observational case report. RESULTS: The authors describe the case of a 69-year-old man referred to their Department because of progressive, bilateral vision loss over the last few months. Deterioration in color vision and intense photophobia were also present. His best-corrected visual acuity was 20/400 in the right eye (RE) and 20/800 in the left eye (LE). Slit lamp and fundus examination failed to show any abnormalities. Spectral domain optical coherence tomography (SD-OCT) detected diffuse attenuation of the ellipsoid layers in addition to a focal subfoveal defect in both eyes. Both fluorescein and indocyanine angiographies (FA and ICGA) were normal. Full flash electroretinogram (ERG) revealed bilateral cone rod dysfunction with decreased amplitudes of both a and b waves. CONCLUSION: Because of the late onset of the disease, poor visual acuity compared with a small macular anatomical lesion and a history of Hodgkin lymphoma 30 years ago, a neoplastic etiology was investigated. Poor performance status and chest pain led to a thoracic CT scan, which identified a massive mediastinal tumor. Serum analysis found an abnormal amount of antibody activity within the 40 kD region of Western blot of retina. The diagnosis of diffuse large B-cell lymphoma was established. Systemic examinations found a Stage IV non-Hodgkin lymphoma.