Effects of B12 Deficiency Anemia on Radial Peripapillary and Macular Vessel Density: An Optical Coherence Tomography Angiography (OCTA) Study

Abstract

Background To evaluate the macular and optic disc vascular changes in vitamin B12 deficiency anemia.

Methods A total of 24 patients with vitamin B12 deficiency anemia and 24 healthy controls were involved in this study. All participants were evaluated for central macular thickness (CMT), peripapillary retina nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ) area, macular vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), choriocapillaris flow area, and optic disc radial peripapillary capillary (RPC) VD using optic coherence tomography (OCT) and optic coherence tomography angiography (OCTA). Metabolic parameters were also noted.

Results Temporal RNFL thickness significantly decreased in the B12 deficiency anemia group (p = 0.04). Choriocapillaris flow area (p = 0.045) and macular vessel density in both SCP (p = 0.022) and DCP (p = 0.018) markedly declined in the study group. Optic disc RPC VD in the B12 deficiency anemia group was lower in all regions compared to that of the control group, but the difference was not statistically significant (p > 0.05). There were significant positive correlations between choriocapillaris flow area, macular VD, vitamin B12, and hemoglobin.

Conclusion Retinal vascular alterations were observed in B12 deficiency anemia, and OCTA may be beneficial in the diagnosis and follow-up of ocular complications in these cases.

Zusammenfassung

Hintergrund Beurteilung der vaskulären Veränderungen der Makula und der Papille bei Vitamin-B₁₂-Mangelanämie.

Methoden In diese Studie wurden insgesamt 24 Patienten mit Vitamin-B₁₂-Mangelanämie und 24 gesunde Kontrollpersonen eingeschlossen. Die zentrale Makuladicke (CMT), die peripapilläre Nervenfaserschicht der Retina (RNFL), der Bereich der fovealen avaskulären Zone (FAZ), die Makulagefäßdichte (VD) im oberflächlichen Kapillarplexus (SCP) und tiefen Kapillarplexus (DCP), die Choriokapillarisflussfläche und Papillen-RPC-VD wurden bei allen Teilnehmern durch optische Kohärenztomografie (OCT) und optische Kohärenztomografieangiografie (OCTA) analysiert. Hierzu wurden auch metabolische Parameter erfasst.

Ergebnisse Die temporale RNFL-Dicke nahm bei der B₁₂-Mangelanämie-Gruppe signifikant ab (p = 0,04). Die Choriokapillarisflussfläche (p = 0,045) und die Makulagefäßdichte sowohl bei SCP (p = 0,022) als auch bei DCP (p = 0,018) nahmen in der Studiengruppe deutlich ab. Die Papillen-RPC-VD bei der B₁₂-Mangelanämie-Gruppe war in allen Regionen niedriger als bei der Kontrollgruppe, jedoch statistisch nicht signifikant (p > 0,05). Es gab signifikante positive Korrelationen zwischen Choriokapillarisflussfläche, Makula-VD und Vitamin B₁₂, Hb.

Schlussfolgerung Bei B₁₂-Mangelanämie sind Gefäßveränderungen in der Retina zu finden. OCTA kann in diesen Fällen zur Diagnose sowie Nachverfolgung der Komplikationen nützlich sein.

Key words

B12 deficiency anemia - macula - optic disc - optical coherence tomography angiography - retina nerve fiber layer

Schlüsselwörter

B₁₂-Mangelanämie - Makula - optische Kohärenztomografieangiografie - Papille - Retina-Nervenfaserschicht

Publication History

Received: 30 November 2021

Accepted: 11 January 2022

Article published online:
23 March 2022

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