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Reduced Retinal Vessel Density in Primary Angle Closure Glaucoma: A Quantitative Study Using Optical Coherence Tomography Angiography.

ABSTRACT: PURPOSE:The purpose of this article is to investigate the changes in the retinal vasculature in different parts of the fundus in eyes with primary angle closure glaucoma (PACG). METHODS:Healthy subjects and those with PACG were enrolled. Optical coherence tomography and a split-spectrum amplitude decorrelation angiography algorithm were used to quantify the retinal vessel densities in the parafoveal and peripapillary areas. RESULTS:Thirty-nine eyes from 24 PACG patients and 39 eyes from 20 age-matched and sex-matched healthy subjects were included. The retinal vessel densities in the parafoveal and peripapillary areas and every sector of the 2 areas were significantly lower in the PACG eyes than in the healthy eyes. The difference was greater in the peripapillary area (11.75%) than in the parafoveal area (7.55%, P<0.05). In the PACG eyes, the vessel density in the peripapillary area correlated closely with the intraocular pressure, but that in the parafoveal area did not. When the PACG eyes were divided into groups with well-controlled and not well-controlled intraocular pressure (?21?mm?Hg or not), the vessel density and retinal nerve fiber layer thickness in the peripapillary area were much lower in the not well-controlled eyes (P<0.05), whereas the vessel density in the parafovea and the ganglion cell complex thickness were similar in the 2 subgroups. CONCLUSION:Retinal vessel density was significantly reduced in PACG eyes. The magnitude of this difference varied between the fundus areas, and was greater in the peripapillary area.

SUBMITTER: Zhu L

PROVIDER: S-EPMC5880710 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Reduced Retinal Vessel Density in Primary Angle Closure Glaucoma: A Quantitative Study Using Optical Coherence Tomography Angiography.

Zhu Li L Zong Yuan Y Yu Jian J Jiang Chunhui C He Yi Y Jia Yali Y Huang David D Sun Xinghuai X

Journal of glaucoma 20180401 4

<h4>Purpose</h4>The purpose of this article is to investigate the changes in the retinal vasculature in different parts of the fundus in eyes with primary angle closure glaucoma (PACG).<h4>Methods</h4>Healthy subjects and those with PACG were enrolled. Optical coherence tomography and a split-spectrum amplitude decorrelation angiography algorithm were used to quantify the retinal vessel densities in the parafoveal and peripapillary areas.<h4>Results</h4>Thirty-nine eyes from 24 PACG patients and ...[more]

PMID: 29419642

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Project description:PurposeTo evaluate optic nerve vascular density using swept source optical coherence tomography angiography (OCTA) in patients with early primary open angle glaucoma (POAG), pre-perimetric glaucoma and normal eyes.MethodsThis is a prospective, observational study including 56 eyes in total and divided into 3 groups; 20 eyes with mild POAG, 20 pre-perimetric glaucoma eyes, and 16 age-matched normal eyes as controls. The optic disc region was imaged by a 1050-nm-wavelength swept-source OCT system (DRI OCT Triton, TOPCON). Vessel density was assessed as the ratio of the area occupied by the vessels in 3 distinct regions: 1) within the optic nerve head; 2) in the 3 mm papillary region around the optic disc; and 3) in the peripapillary region, defined as a 700-μm-wide elliptical annulus around the disc. The potential associations between vessel density and structural, functional measures were analyzed.ResultsThere was a statistically significant difference for the peripapillary vessel density, optic nerve head vessel density, and papillary vessel density among all the groups (p<0.001). Control eyes showed a significant difference for all measured vessel densities compared to glaucomatous eyes (p values from 0.001 to 0.024). There was a statistically significant difference between control and pre-perimetric glaucoma eyes for peripapillary, optic nerve head and papillary vessel density values (p values from 0.001 to 0.007). The optic nerve head vessel density, superior and inferior papillary area vessel density (Pearson r = 0.512, 0.436, 0.523 respectively) were highly correlated with mean overall, superior and inferior RNFL thickness in POAG eyes (p = 0.04, p = 0.02 and p = 0.04 respectively). Multiple linear regression analysis of POAG group showed that optic nerve head vessel density in POAG group was more strongly linked to RNFL thickness than to any other variables.ConclusionsEyes with mild POAG could be differentiated from pre-perimetric glaucoma eyes, which also could be differentiated from normal eyes using OCTA-derived retinal vessel density measurements.

Project description:PURPOSE:To detect macular perfusion defects in glaucoma using projection-resolved optical coherence tomography (OCT) angiography. DESIGN:Prospective observation study. PARTICIPANTS:A total of 30 perimetric glaucoma and 30 age-matched normal participants were included. METHODS:One eye of each participant was imaged using 6×6-mm macular OCT angiography (OCTA) scan pattern by 70-kHz 840-nm spectral-domain OCT. Flow signal was calculated by the split-spectrum amplitude-decorrelation angiography algorithm. A projection-resolved OCTA (PR-OCTA) algorithm was used to remove flow projection artifacts. Four en face OCTA slabs were analyzed: the superficial vascular complex (SVC), intermediate capillary plexus (ICP), deep capillary plexus (DCP), and all-plexus retina (SVC + ICP + DCP). The vessel density (VD), defined as the percentage area occupied by flow pixels, was calculated from en face OCTA. A novel algorithm was used to adjust the vessel density to compensate for local variations in OCT signal strength. MAIN OUTCOME MEASURES:Macular retinal VD, ganglion cell complex (GCC) thickness, and visual field (VF) sensitivity. RESULTS:Focal capillary dropout could be visualized in the SVC, but not the ICP and DVP, in glaucomatous eyes. In the glaucoma group, the SVC and all-plexus retinal VD (mean ± standard deviation: 47.2%±7.1% and 73.5%±6.6%) were lower than in the normal group (60.5%±4.0% and 83.2%±4.2%, both P < 0.001, t test). The ICP and DCP VD were not significantly lower in the glaucoma group. Among the overall macular VD parameters, the SVC VD had the best diagnostic accuracy as measured by the area under the receiver operating characteristic curve (AROC). The accuracy was even better when the worse hemisphere (inferior or superior) was used, achieving an AROC of 0.983 and a sensitivity of 96.7% at a specificity of 95%. Among the glaucoma participants, the hemispheric SVC VD values were highly correlated with the corresponding GCC thickness and VF sensitivity (P < 0.003). The reflectance compensation step in VD calculation significantly improved repeatability, normal population variation, and correlation with VF and GCC thickness. CONCLUSIONS:On the basis of PR-OCTA, glaucoma preferentially affects perfusion in the SVC in the macula more than the deeper plexuses. Reflectance-compensated SVC VD measurement by PR-OCTA detected glaucoma with high accuracy and could be useful in the clinical evaluation of glaucoma.

Project description:PurposeTo compare the retinal vessel density and glaucomatous parameters in primary angle closure glaucoma (PACG), to evaluate the diagnostic and monitoring abilities of the peripapillary and macular vessel density in the progression of glaucoma.MethodsThis was a observational, prospective and cross-sectional study. According to Glaucoma Staging System, 218 eyes (116 participants) were divided into 5 groups: no glaucoma, early glaucoma, moderate glaucoma, advance glaucoma, severe glaucoma. All participants underwent a comprehensive ocular examination, which included corrected distance visual acuity measurement, slit-lamp biomicroscopy, intra ocular pressure (IOP), gonioscopy, fundus examination, stereoscopic optic disc photography, Humphrey visual field test(VF), peripapillary and macular optical coherence tomography angiography(OCTA) scan. SPSS software was used to calculate and compare retinal vessel density (peripapillary vessel density, PVD and macular vessel density, MVD) and glaucomatous parameters (mean deviation (MD),pattern standard deviation(PSD), retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer(GCIPL),rim area, average cup/disc(C/D) ratio).ResultsThe GCIPL thickness, RNFL thickness, PVD and MVD are significantly reduced in PACG. There were significant differences in all measurements among the groups (P<0.01).Reduced peripapillary and macular vessel density in glaucoma were detected and a statistically significant correlation with glaucoma stages (P<0.01). In addition, the results of retinal vessel density, reduced RNFL thickness and GCIPL thickness were also statistically related to the stage of glaucoma. As expected, the rim area was significantly smaller with higher C/D area ratios in glaucomatous eyes corresponding to the severity of disease.ConclusionsThe changes of PVD and MVD had strongly positive correlation with GCIPL thickness and RNFL thickness, had negative correlation with the severity of glaucoma, which meant the more severe the glaucoma was, the lower PVD and MVD were. Compared to traditional glaucoma staging system judged by VF, the changes of PVD and MVD obtained by OCTA might be a new method to grade the stage of glaucoma. These findings theorize that the changes of PVD and MVD may be better facilitated for the observation and monitoring of glaucoma progression.

Dataset Information

Reduced Retinal Vessel Density in Primary Angle Closure Glaucoma: A Quantitative Study Using Optical Coherence Tomography Angiography.

Publications

Reduced Retinal Vessel Density in Primary Angle Closure Glaucoma: A Quantitative Study Using Optical Coherence Tomography Angiography.

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