Research Article: Analysis of macular and optic nerve vasculature using optical coherence tomography angiography in patients with human T-cell lymphotropic virus type 1
Abstract:
To compare macular and optic nerve head (ONH) microvasculature using optical coherence tomography angiography (OCT-A) in asymptomatic human T-cell lymphotropic virus type 1 (HTLV-1) carriers and patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), in search of potential biomarkers of disease development.
Pilot study analyzing quantitative OCT-A parameters of the macula and ONH vasculature in asymptomatic HTLV-1 carriers (group 1) and patients with HAM/TSP (group 2).
Up to 41 eyes of 21 patients were included. Macular total vessel density and perfusion density (PD) were 18.72?mm/mm 2 [95% CI: 17.58–19.86] and 32.34% [95% CI: 29.95–34.92] in group 1 vs. 18.32?mm/mm 2 [95% CI: 17.06–19.58] ( p =?0.59) and 32.19% [95% CI: 29.45–35.16] ( p =?1) in group 2. Foveal avascular zone area, perimeter and circularity were similar in both groups (0.255?mm 2 [95% CI: 0.157–0.354] vs. 0.293?mm 2 [95% CI: 0.180–0.406], p =?0.41, 2.124?mm [95% CI: 1.782–2.531] vs. 2.344?mm [95% CI: 1.916–2.867], p =?0.41, and 0.634 [95% CI: 0.588–0.680] vs. 0.603 [95% CI: 0.551–0.655], p =?0.32, in group 1 vs. group 2 respectively). Peripapillary PD and flux index (FI) were 43.95% [95% CI: 42.90–45.03] vs. 43.19% [95% CI: 42.01–44.40], p =?0.29, and 0.425 [95% CI: 0.41–0.44] vs. 0.403 [95% CI: 0.38–0.42], p =?0.08, in group 1 vs. group 2, respectively.
Despite limitations related to sample size and disease rarity, this pilot study revealed no statistically significant differences in the macular and ONH microvascular parameters assessed by OCT-A between HAM/TSP patients and asymptomatic HTLV-1 carriers. Further investigations are needed in larger longitudinal multicenter studies regarding the peripapillary FI, which tends to be lower in patients with HAM/TSP.
Introduction:
Infection with human T-cell lymphotropic virus type 1 (HTLV-1), the first retrovirus discovered in humans, is endemic in the West Indies and French Guiana ( 1 ). Mostly asymptomatic, it can also present with various clinical manifestations (mainly hematological neoplastic diseases, neurological or ocular inflammatory syndromes) ( 2 ). Approximately 20 million people are infected worldwide, but less than 5% will develop neurological complications ( 3 ). In Caribbean endemic areas, the most common manifestation is…
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