Microvascular alterations in children with optic disk drusen evaluated by optical coherence tomography angiography

Purpose To asses changes in vessel density (VD) in children with optic disk drusen (ODD) using swept source optical coherence tomography angiography (OCTA). Methods Cross-sectional study of 27 eyes with ODD compared with age-matched controls. Peripapillary and macular VD were measured in the superficial retinal capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). The correlation between VD changes with alterations in retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and visual field (VF) was analyzed. Results Mean participant age was 12.5 ± 3.3 years (range, 7–18 years); 63% was females. In the patients vs. controls, median central peripapillary VD was 52.9% vs. 50.6% ( p = 0.63) for SCP; 48.1% vs. 53.8% ( p = 0.017) for DCP; and 17.0% vs. 28.2% ( p = 0.0037) for CC, respectively. VD in the superior and nasal CC layers was significantly lower in the patients (36.3% vs. 56.2%; p < 0.001) and (60.4% vs. 70.3%, p < 0.001), respectively. No significant differences were observed for VD in the macular region. The RNFL was thinner in eyes with superficial drusen versus controls (87 vs. 111 μm; p < 0.001). No significant differences between were observed in GCL thickness ( p = 0.13). Nasal SCP and nasal RNFL VD were moderately correlated ( r = 0.54, p < 0.01), while mean VF deviation was strongly correlated with median SCP VD in patients with superficial drusen ( r = 0.9, p = 0.03). Conclusion Impaired VD was observed in the peripapillary nasal CC in patients with ODD; this impairment was associated with a decreased RNFL thickness. Nasal SCP VD and RNFL thickness were moderately correlated in patients with ODD.