Dataset Information

Association of macular vessel density and ganglion cell complex thickness with central visual field progression in glaucoma.

ABSTRACT:

Background/aims

To evaluate the association of macular vessel density (VD) and ganglion cell complex (GCC) thickness with 10-2 central visual field (CVF) progression in glaucoma.

Methods

In this retrospective cohort study, patients with glaucoma from Diagnostic Innovation in Glaucoma Study with≥five 10-2 visual field (VF) tests and 3-year follow-up before optical coherence tomography (OCT) and OCT angiography (OCTA) imaging were included. Whole-image GCC thickness (wiGCC) and superficial VD (wiVD) were obtained from 6*6 macula scans. The association of wiVD and wiGCC with past rate of 10-2 VF mean deviation worsening, and with past CVF progression (defined using clustered linear regression criteria) was evaluated using linear mixed models after adjusting for confounders.

Results

From 238 eyes (141 patients), 25 eyes (11%) of 16 patients were CVF progressors. In the multivariable analysis of the association between OCT/OCTA parameters and past rate of 10-2 CVF worsening, lower wiVD (β=-0.04 (-0.05, -0.02); p<0.001; R²=0.32) and wiGCC (β=-0.01 (-0.01, 0.00); p=0.004; R²=0.21) were significantly associated with faster CVF worsening. For the association between OCT/OCTA parameters and past CVF progression, the multivariable analysis showed that a lower wiVD was significantly associated with increased odds of past CVF progression (OR=1.23 (1.06, 1.44) per 1% lower; p=0.008), while wiGCC did not show correlation.

Conclusions

Lower macular VD and GCC were associated with faster worsening of CVF, and lower macular VD was associated with increased odds of CVF progression. Assessment of macular OCT and OCTA may help detect glaucoma eyes with CVF progression.

SUBMITTER: Wu JH

PROVIDER: S-EPMC10033463 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Publications

Association of macular vessel density and ganglion cell complex thickness with central visual field progression in glaucoma.

Wu Jo-Hsuan JH Moghimi Sasan S Nishida Takashi T Mahmoudinezhad Golnoush G M Zangwill Linda L Weinreb Robert N RN

The British journal of ophthalmology 20231122 12

<h4>Background/aims</h4>To evaluate the association of macular vessel density (VD) and ganglion cell complex (GCC) thickness with 10-2 central visual field (CVF) progression in glaucoma.<h4>Methods</h4>In this retrospective cohort study, patients with glaucoma from Diagnostic Innovation in Glaucoma Study with≥five 10-2 visual field (VF) tests and 3-year follow-up before optical coherence tomography (OCT) and OCT angiography (OCTA) imaging were included. Whole-image GCC thickness (wiGCC) and supe ...[more]

PMID: 36150750

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Project description:PURPOSE:To characterize OCT angiography (OCT-A) vessel density of patients with primary open-angle glaucoma (POAG) with unilateral visual field (VF) loss. DESIGN:Cross-sectional study. PARTICIPANTS:A total of 33 patients with POAG with a VF defect in 1 eye (mean VF mean deviation [MD], -3.9±3.1 decibels [dB]) and normal VF in the other eye (mean VF MD, -0.2±0.9 dB) and 33 healthy eyes. METHODS:All subjects underwent OCT-A imaging, spectral-domain (SD)-OCT imaging, and VF testing. OCT-A retinal vascular measurements were summarized as whole image vessel density (wiVD), circumpapillary vessel density (cpVD), and parafoveal vessel density (pfVD). Inter-eye differences in vascular measures, as well as SD OCT retinal nerve fiber layer (RNFL), macular ganglion cell complex (mGCC) thickness, and rim area measurements in glaucoma and healthy eyes were compared. Areas under the receiver operating characteristic curves (AUROCs) were used to evaluate diagnostic accuracy for differentiating between unaffected eyes of patients with POAG and healthy eyes. MAIN OUTCOME MEASURES:Difference in OCT-A vessel density and SD OCT structural parameters between unaffected eyes of patients with POAG with the fellow affected eyes and healthy controls. RESULTS:Mean wiVD in unaffected eyes of patients with POAG (52.0%) was higher than in their fellow affected eyes (48.8%) but lower than in healthy eyes (55.9%; P < 0.001). Mean circumpapillary RNFL (cpRNFL) thickness, mGCC thickness, and rim area measurement in unaffected eyes of patients with POAG (87.5 μm, 87.7 μm, and 1.0 mm2) were also higher than those measurements in their fellow eyes (76.5 μm, 79.5 μm, and 0.8 mm2; P < 0.001) and lower than in healthy eyes (98.0 μm, 94.5 μm, and 1.4 mm2; P < 0.001). The AUROCs for differentiating unaffected eyes of patients with POAG from healthy eyes were highest for wiVD (0.84), followed by mGCC (0.78), cpRNFL (0.77), and pfVD (0.69). CONCLUSIONS:OCT-A measures detect changes in retinal microvasculature before VF damage is detectable in patients with POAG, and these changes may reflect damage to tissues relevant to the pathophysiology of glaucoma. Longitudinal studies are needed to determine whether OCT-A measures can improve the detection or prediction of the onset and progression of glaucoma.

Project description:Importance:Investigating the vascular risk factors of glaucoma progression is important to individualize treatment; however, few studies have investigated these factors because the available methods have proven insufficient to evaluate the vascular features of patients with glaucoma. Recently, the advent of optical coherence tomography angiography (OCT-A) allowed both qualitative and quantitative microvascular data to be obtained, to in turn evaluate the perfusion status of different retinal layers. Objective:To determine whether baseline parapapillary choroidal vessel density (VD) as measured by OCT-A was associated with future glaucoma progression. Design, Setting, and Participants:A prospective, observational, comparative study was conducted at Seoul St Mary's Hospital of The Catholic University of Korea from March 1, 2016, to December 31, 2018, for 108 glaucomatous eyes in which the retinal nerve fiber layer thickness and mean deviation were measured by at least 5 serial OCT and visual field (VF) examinations. The participants underwent OCT-A at baseline. Vessel density was measured using the en face image of the choroidal map of OCT-A within the β-zone parapapillary atrophy region. Main Outcomes and Measures:Parapapillary choroidal VD, retinal nerve fiber layer thinning rate, mean deviation rate, and progression of glaucoma as measured by OCT and VF. Results:Among 108 patients (74 women and 34 men; mean [SD] age, 59.2 [13.1] years), 38 (35.2%) showed progression of glaucoma as measured by OCT and 34 (31.5%) showed progression of glaucoma as measured by VF at the last follow-up. The mean (SD) follow-up duration was 2.6 [2.3] years. The presence of disc hemorrhage (odds ratio, 5.57; 95% CI, 3.18-8.29; P = .001), baseline mean deviation (odds ratio, 0.83; 95% CI, 0.71-0.97; P = .02), and parapapillary choroidal VD (odds ratio, 1.18; 95% CI, 1.09-1.28; P = .01) were associated with progression of glaucoma as measured by VF, but not with progression of glaucoma as measured by OCT. Baseline parapapillary choroidal VD (β, 1.08; 95% CI, 1.02-1.13; P < .001) was associated with progression of glaucoma as measured by VF using Cox proportional hazards regression analysis. Conclusions and Relevance:These data suggest that lower parapapillary choroidal VD within the β-zone parapapillary atrophy at baseline among individuals with glaucoma could play some role in the risk of progression of glaucoma as measured by VF. The findings suggest that patients with glaucoma with lower parapapillary choroidal VD within the β-zone parapapillary atrophy at baseline warrant careful monitoring for progression of glaucoma as measured by VF.

Dataset Information

Association of macular vessel density and ganglion cell complex thickness with central visual field progression in glaucoma.

Background/aims

Methods

Results

Conclusions

Publications

Association of macular vessel density and ganglion cell complex thickness with central visual field progression in glaucoma.

Similar Datasets

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