Dataset Information

Relationship Between Central Retinal Vessel Trunk Location and Visual Field Loss in Glaucoma.

ABSTRACT: To study the relationship between horizontal central retinal vessel trunk location (CRVTL) on glaucomatous optic discs and sector-specific visual field (VF) loss.Retrospective cross-sectional study.CRVTL of 421 eyes from 421 patients was manually tracked on the horizontal optic disc axis on fundus images. Focal circumpapillary retinal nerve fiber layer thickness (cpRNFLT) measurements were extracted from optical coherence tomography (OCT). The relationship between focal visual field (VF) loss and CRVTL and focal cpRNFLT was studied by linear regression models. Furthermore, we related central VF loss to CRVTL and focal cpRNFLT separately for mild (VF mean deviation [MD] ?-6 dB), moderate (-12 dB ? MD <-6 dB), and severe (MD <-12 dB) glaucoma.CRVTL nasalization was significantly correlated only to central VF loss (Garway-Heath scheme [central 6 locations, C6]: correlation: r = -0.16, P < .001; macular vulnerability zone [central 2 locations, C2]: r = -0.14, P = .003; central 4 locations [C4]: r = -0.17, P < .001). While focal cpRNFLT at the sectors corresponding to C2 and C6 was significantly correlated to the respective VF sectors as well (C2: r = 0.15, P = .002; C6: r = 0.10, P = .03), multivariate models combining cpRNFLT and CRVTL substantially improved structure-function models compared with cpRNFLT alone (likelihood ratio tests, C2 and C6: P < .001). The correlations between CRVTL and central VF loss of C4 were -0.11 (P = .04), -0.39 (P = .01), and -0.63 (P = .002) for mild, moderate, and severe glaucoma, respectively.CRVTL nasalization is significantly and exclusively correlated to central VF loss for all glaucoma severities independent of cpRNFLT, and thus might be a structural biomarker of central VF loss.

SUBMITTER: Wang M

PROVIDER: S-EPMC5376509 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Relationship Between Central Retinal Vessel Trunk Location and Visual Field Loss in Glaucoma.

Wang Mengyu M Wang Hui H Pasquale Louis R LR Baniasadi Neda N Shen Lucy Q LQ Bex Peter J PJ Elze Tobias T

American journal of ophthalmology 20170111

<h4>Purpose</h4>To study the relationship between horizontal central retinal vessel trunk location (CRVTL) on glaucomatous optic discs and sector-specific visual field (VF) loss.<h4>Design</h4>Retrospective cross-sectional study.<h4>Methods</h4>CRVTL of 421 eyes from 421 patients was manually tracked on the horizontal optic disc axis on fundus images. Focal circumpapillary retinal nerve fiber layer thickness (cpRNFLT) measurements were extracted from optical coherence tomography (OCT). The relat ...[more]

PMID: 28088508

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Project description:ImportanceAlthough the central visual field (VF) in end-stage glaucoma may substantially vary among patients, structure-function studies and quality-of-life assessments are impeded by the lack of appropriate characterization of end-stage VF loss.ObjectiveTo provide a quantitative characterization and classification of central VF loss in end-stage glaucoma.Design, setting, and participantsThis retrospective cohort study collected data from 5 US glaucoma services from June 1, 1999, through October 1, 2014. A total of 2912 reliable 10-2 VFs of 1103 eyes from 1010 patients measured after end-stage 24-2 VFs with a mean deviation (MD) of -22 dB or less were included in the analysis. Data were analyzed from March 28, 2018, through May 23, 2019.Main outcomes and measuresCentral VF patterns were determined by an artificial intelligence algorithm termed archetypal analysis. Longitudinal analyses were performed to investigate whether the development of central VF defect mostly affects specific vulnerability zones.ResultsAmong the 1103 patients with the most recent VFs, mean (SD) age was 70.4 (14.3) years; mean (SD) 10-2 MD, -21.5 (5.6) dB. Fourteen central VF patterns were determined, including the most common temporal sparing patterns (304 [27.5%]), followed by mostly nasal loss (280 [25.4%]), hemifield loss (169 [15.3%]), central island (120 [10.9%]), total loss (91 [8.3%]), nearly intact field (56 [5.1%]), inferonasal quadrant sparing (42 [3.8%]), and nearly total loss (41 [3.7%]). Location-specific median total deviation analyses partitioned the central VF into a more vulnerable superonasal zone and a less vulnerable inferotemporal zone. At 1-year and 2-year follow-up, new defects mostly occurred in the more vulnerable zone. Initial encroachments on an intact central VF at follow-up were more likely to be from nasal loss (11 [18.4%]; P < .001). One of the nasal loss patterns had a substantial chance at 2-year follow-up (8 [11.0%]; P = .004) to shift to total loss, whereas others did not.Conclusions and relevanceIn this study, central VF loss in end-stage glaucoma was found to exhibit characteristic patterns that might be associated with different subtypes. Initial central VF loss is likely to be nasal loss, and 1 specific type of nasal loss is likely to develop into total loss.

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.

Dataset Information

Relationship Between Central Retinal Vessel Trunk Location and Visual Field Loss in Glaucoma.

Publications

Relationship Between Central Retinal Vessel Trunk Location and Visual Field Loss in Glaucoma.

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