Philipp Albrecht1, Christine Blasberg2, Sebastian Lukas2, Marius Ringelstein2, Ann-Kristin Müller2, Jens Harmel2, Ella-Maria Kadas2, David Finis2, Rainer Guthoff2, Orhan Aktas2, Hans-Peter Hartung2, Friedemann Paul2, Alexander U Brandt2, Peter Berlit2, Axel Methner2, Markus Kraemer2. 1. From the Departments of Neurology (P.A., C.B., M.R., A.-K.M., J.H., O.A., H.-P.H.) and Ophthalmology (D.F., R.G.), Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Neurology Clinic (S.L.), Department of Clinical Neuroimmunology and Multiple Sclerosis Research, University Medical Center Zürich, Switzerland; Charité-Universitätsmedizin Berlin (E.-M.K., F.P., A.U.B.), NeuroCure Clinical Research Center and Department of Neurology, Berlin; Department of Neurology (A.M.), University Medical Center, Johannes Gutenberg University Mainz; and Department of Neurology (P.B., M.K.), Alfried Krupp Hospital, Essen, Germany. phil.albrecht@gmail.com. 2. From the Departments of Neurology (P.A., C.B., M.R., A.-K.M., J.H., O.A., H.-P.H.) and Ophthalmology (D.F., R.G.), Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Neurology Clinic (S.L.), Department of Clinical Neuroimmunology and Multiple Sclerosis Research, University Medical Center Zürich, Switzerland; Charité-Universitätsmedizin Berlin (E.-M.K., F.P., A.U.B.), NeuroCure Clinical Research Center and Department of Neurology, Berlin; Department of Neurology (A.M.), University Medical Center, Johannes Gutenberg University Mainz; and Department of Neurology (P.B., M.K.), Alfried Krupp Hospital, Essen, Germany.
Abstract
OBJECTIVE: To investigate whether patients with moyamoya angiopathy without obvious retinal pathologies such as retinal infarctions or the congenital morning glory anomaly may have subtle subclinical retinal changes. METHODS: In this cross-sectional study, spectral domain optical coherence tomography was used to analyze the retinal morphology of 25 patients with idiopathic moyamoya angiopathy and 25 age- and sex-matched healthy controls. We analyzed the retinal vasculature with blue laser autofluorescence, lipofuscin deposits with MultiColor confocal scanning laser ophthalmoscopy, and the optic nerve head (ONH) volume with a custom postprocessing algorithm. In addition to the total retinal thickness, semiautomated segmentation was used for segmentation of retinal layers in macular cross scans, macular volume scans, and peripapillary ring scans. RESULTS: The main finding was a pronounced reduction of the ONH volume in moyamoya angiopathy compared with controls (0.76 ± 0.45 mm(3) and 1.47 ± 0.50 mm(3), respectively; p < 0.0001), which was associated with a less pronounced reduction of the retinal nerve fiber layer in macular volume scans (0.97 ± 0.11 mm(3) and 1.10 ± 0.10 mm(3), respectively; p < 0.001). Autofluorescence and MultiColor confocal scanning laser ophthalmoscopy images revealed no pathologies except for one branch retinal artery occlusion. CONCLUSION: Our results indicate that even patients with moyamoya angiopathy who do not have obvious retinal abnormalities have retinal abnormalities. These can be detected by spectral domain optical coherence tomography, and the association of ONH abnormalities with the vascular changes may suggest that idiopathic moyamoya angiography is a systemic disease involving abnormalities of the early mesodermal development.
OBJECTIVE: To investigate whether patients with moyamoya angiopathy without obvious retinal pathologies such as retinal infarctions or the congenital morning glory anomaly may have subtle subclinical retinal changes. METHODS: In this cross-sectional study, spectral domain optical coherence tomography was used to analyze the retinal morphology of 25 patients with idiopathic moyamoya angiopathy and 25 age- and sex-matched healthy controls. We analyzed the retinal vasculature with blue laser autofluorescence, lipofuscin deposits with MultiColor confocal scanning laser ophthalmoscopy, and the optic nerve head (ONH) volume with a custom postprocessing algorithm. In addition to the total retinal thickness, semiautomated segmentation was used for segmentation of retinal layers in macular cross scans, macular volume scans, and peripapillary ring scans. RESULTS: The main finding was a pronounced reduction of the ONH volume in moyamoya angiopathy compared with controls (0.76 ± 0.45 mm(3) and 1.47 ± 0.50 mm(3), respectively; p < 0.0001), which was associated with a less pronounced reduction of the retinal nerve fiber layer in macular volume scans (0.97 ± 0.11 mm(3) and 1.10 ± 0.10 mm(3), respectively; p < 0.001). Autofluorescence and MultiColor confocal scanning laser ophthalmoscopy images revealed no pathologies except for one branch retinal artery occlusion. CONCLUSION: Our results indicate that even patients with moyamoya angiopathy who do not have obvious retinal abnormalities have retinal abnormalities. These can be detected by spectral domain optical coherence tomography, and the association of ONH abnormalities with the vascular changes may suggest that idiopathic moyamoya angiography is a systemic disease involving abnormalities of the early mesodermal development.
Authors: Kay Gawlik; Frank Hausser; Friedemann Paul; Alexander U Brandt; Ella Maria Kadas Journal: Biomed Opt Express Date: 2018-11-28 Impact factor: 3.732
Authors: Philipp Albrecht; Christine Blasberg; Marius Ringelstein; Ann-Kristin Müller; David Finis; Rainer Guthoff; Ella-Maria Kadas; Wolf Lagreze; Orhan Aktas; Hans-Peter Hartung; Friedemann Paul; Alexander U Brandt; Axel Methner Journal: J Neurol Date: 2017-06-05 Impact factor: 4.849
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Authors: Daniel Bremer; Florence Pache; Robert Günther; Jürgen Hornow; Volker Andresen; Ruth Leben; Ronja Mothes; Hanna Zimmermann; Alexander U Brandt; Friedemann Paul; Anja E Hauser; Helena Radbruch; Raluca Niesner Journal: Front Immunol Date: 2016-12-23 Impact factor: 7.561
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Authors: Axel Petzold; Philipp Albrecht; Laura Balcer; Erik Bekkers; Alexander U Brandt; Peter A Calabresi; Orla Galvin Deborah; Jennifer S Graves; Ari Green; Pearse A Keane; Jenny A Nij Bijvank; Josemir W Sander; Friedemann Paul; Shiv Saidha; Pablo Villoslada; Siegfried K Wagner; E Ann Yeh Journal: Ann Clin Transl Neurol Date: 2021-05-19 Impact factor: 4.511
Authors: Andrés Cruz-Herranz; Lisanne J Balk; Timm Oberwahrenbrock; Shiv Saidha; Elena H Martinez-Lapiscina; Wolf A Lagreze; Joel S Schuman; Pablo Villoslada; Peter Calabresi; Laura Balcer; Axel Petzold; Ari J Green; Friedemann Paul; Alexander U Brandt; Philipp Albrecht Journal: Neurology Date: 2016-05-25 Impact factor: 9.910