{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:03:11Z","timestamp":1785538991001,"version":"3.56.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T00:00:00Z","timestamp":1632268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Purpose:<\/jats:bold> We examined the macular microvascular changes of the macula in neuromyelitis optica spectrum disorder (NMOSD) patients and its association with their disability and other clinical variables.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Thirty-four NMOSD (13 patients without optic neuritis, NMOSD-NON, and 21 patients with a history of optic neuritis, NMOSD-ON) and 44 healthy controls (HCs) were included in the study. Optical coherence tomographic angiography (OCTA) was used to image the superficial (SCP), deep (DCP), and whole capillary plexus (WCP) in a 2.5-mm-diameter concentric circle [excluding the foveal avascular zone (FAZ)]. An algorithm (D<jats:sub>box<\/jats:sub>) was used to quantify the complexity of the three capillary layers by fractal analysis. We also evaluated the expanded disability scale status (EDSS).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> D<jats:sub>box<\/jats:sub> values were significantly reduced in SCP (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), DCP (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), and WCP (<jats:italic>p<\/jats:italic> = 0.003) of NMOSD when compared with HCs. D<jats:sub>box<\/jats:sub> values were significantly reduced in NMOSD eyes with optic neuritis when compared with healthy controls (<jats:italic>p<\/jats:italic> &amp;lt; 0.001) and eyes without optic neuritis (<jats:italic>p<\/jats:italic> = 0.004) in the SCP. In the DCP, eyes with optic neuritis showed significantly reduced D<jats:sub>box<\/jats:sub> values when compared with eyes without optic neuritis (<jats:italic>p<\/jats:italic> = 0.016) and healthy controls (<jats:italic>p<\/jats:italic> &amp;lt; 0.001); eyes without optic neuritis showed significantly reduced D<jats:sub>box<\/jats:sub> values (<jats:italic>p<\/jats:italic> = 0.007) in the DCP when compared with healthy controls. A significant negative correlation (Rho = \u22120.475, <jats:italic>p<\/jats:italic> = 0.005) was shown between the superficial macula D<jats:sub>box<\/jats:sub> values and the EDSS in NMOSD patients. Additionally, a negative correlation (Rho = \u22120.715, <jats:italic>p<\/jats:italic> = 0.006) was seen in the superficial D<jats:sub>box<\/jats:sub> values in [e]eyes without optic neuritis and EDSS.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Macular microvascular damage in the superficial plexus is associated with disability in NMOSD. Macular microvascular alterations arise independently of the occurrence of ON in NMOSD.<\/jats:p>","DOI":"10.3389\/fneur.2021.724946","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T05:43:37Z","timestamp":1632289417000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Superficial Macula Capillary Complexity Changes Are Associated With Disability in Neuromyelitis Optica Spectrum Disorders"],"prefix":"10.3389","volume":"12","author":[{"given":"Ruili","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyang","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huihui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangping","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangxia","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yitian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1212\/WNL.0000000000001729","article-title":"International 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