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 = .006 and P < .001). RNFL and GCL thicknesses were significantly lower in patients with ONHD (81.81 and 77.43 µm, respectively) than in controls (91.38 and 81.97 µm, respectively) (P = .001 and P = .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.