Quantitative assessment of macular and circumpapillary retinal vessel density across all stages of Leber hereditary optic neuropathy using swept source optical coherence tomography angiography

Purpose To investigate the macular and circumpapillary retinal microvasculature across all stages of Leber hereditary optic neuropathy (LHON) using swept source optical coherence tomography angiography (OCTA). Methods This prospective, multicentre, cross‐sectional, observational study analysed a total of 119 eyes of 60 patients with molecularly confirmed LHON across all stages and 120 eyes of 60 control subjects. Optical coherence tomography angiography maps centred on the fovea and optic disc were obtained to measure vessel densities (VDs) in the macular superficial (SCP) and deep (DCP) capillary plexuses, and the radial peripapillary capillary plexus (RPCP) respectively. Results In asymptomatic eyes, only the SCP showed significant changes on average (B coefficient = −0.72, 95% CI = −1.34 to −0.10, p = 0.022) or in sectors representing the papillomacular bundle (PMB) (B coefficient = −1.17, 95% CI = −2.23 to −0.11, p = 0.031). However, in chronic eyes, the greatest magnitude of change was found in the temporal sector of the RPCP (B coefficient = −12.36, 95% CI = −14.49 to −10.23, p