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. 2023 Nov;261(11):3263-3274.
doi: 10.1007/s00417-023-06171-5. Epub 2023 Jul 22.

Cytomegalovirus-positive Posner-Schlossman syndrome: to compare differences in retinal vessel area density between the affected and non-affected eye using optical coherence tomography angiography

Patricia Hülse  1 , Emanuel Reitemeyer  1 , Anne Rübsam  1 , Uwe Pleyer #  1 , Anna-Karina B Maier #  2
Affiliations

Cytomegalovirus-positive Posner-Schlossman syndrome: to compare differences in retinal vessel area density between the affected and non-affected eye using optical coherence tomography angiography

Patricia Hülse et al. Graefes Arch Clin Exp Ophthalmol. 2023 Nov.

Abstract

Purpose: To analyse differences in the retinal microvasculature in eyes with cytomegalovirus (CMV)-positive Posner-Schlossman syndrome (PSS) compared to the non-affected eyes using optical coherence tomography angiography (OCTA).

Methods: In this monocentric, observational prospective case series, 25 patients with unilateral CMV-positive PSS were included. We compared the vessel area densities (VAD) in the macula, optic disc, and peripapillary region in PSS-affected and non-affected eyes using OCTA. We compared the visual fields (VF) of the affected and healthy eyes of each patient. The mean deviation (MD) of the VF was analysed together with the retinal nerve fibre layer (RNFL) thickness to evaluate the strength of correlation with the VAD parameters.

Results: The VAD of the peripapillary superficial vascular complex (SVC) is significantly reduced in CMV-positive PSS-affected eyes (46.1 ± 9.3% versus 50.1 ± 6.3%, p = 0.008, adjusted p = 0.048). The VAD of the deeper macular, papillary, and peripapillary layers showed no differences between the affected and non-affected eyes. The mean deviation and the retinal nerve fibre layer thickness had correlations with the VAD of the macula (r = 0.451, p = 0.001, r = 0.553, p < 0.001), the peripapillary SCV (r = 0.430, p = 0.002, r = 0.723, p < 0.001), and the papillary region (r = 0.512, p < 0.001, r = 0.292, p = 0.039). Patients receiving systemic antiviral therapy (SAT) showed better VAD of the peripapillary choriocapillary layer (p = 0.001, no therapy: 31.4 ± 1.9%, SAT: 35.0 ± 1.6%), and choroidal layer (p = 0.009, no therapy: 34.2 ± 0.3%, SAT: 36.3 ± 1.8%) compared to those with no SAT.

Conclusion: A lower peripapillary VAD in the SVC might indicate vascular dysfunction as a sign of glaucomatous damage. SAT might have positive effects on the microcirculation in the deep retinal and choroidal layers.

Trial registration: TRN: DRKS00028266, https://www.drks.de/drks_web/ .

Keywords: Cytomegalovirus; Glaucoma; OCT angiography; Posner-Schlossman syndrome; Uveitis; Vessel density.

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Conflict of interest statement

P.H. and E.R. report no financial interests. AR received speaking honoraria from Bayer Healthcare, Roche, and Novartis and served as a consultant for Novartis. AR receives research support from Deutsche Forschungsgemeinschaft (DFG) (RU 2020/3-1). A.-K. M. has served as a consultant for Allergan and Novartis. U.P. has served as a principal investigator or consultant for AbbVie, Alcon, Allergan, Alimera, Bayer, Dompé, Novartis, Santen, Shire, and Thea.

Figures

Fig. 1
Fig. 1
Example pictures of the OCTA en-face images: A1—macula, A2—optic disc, A3—superficial vascular complex, A4—deep vascular complex, A5—choriocapillary layer, A6—choroidal layer. The corresponding binarized images are represented in B1 to B6 with a peripapillary circle of 750 μm
See this image and copyright information in PMC

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