Abstract
PurposeTo compare the diagnostic accuracy of structural parameters, vessel density (VD) measured by optical coherence tomography angiography (OCTA), and electrophysiological testing in diagnosis of primary open-angle glaucoma (POAG).Methods35 healthy participants and 90 POAG subjects underwent the measurement of whole image en face (wi) VD in the disc/peripapillary region and macula, the retinal nerve fiber layer (RNFL), and the average thickness of ganglion cell complex (GCC), pattern electroretinograms and pattern visual evoked potentials. The area under the receiver operating characteristic curve (AUC) was assessed for each parameter to differentiate early POAG from healthy eyes and between the POAG stages.ResultsTo distinguish early POAG from healthy eyes, the parameters with the highest AUC were detected: P50 amplitude of transient pattern electroretinogram, 1° (AUC 0.93, p = 0.002), P1 component of steady-state pattern electroretinogram (AUC 0.92, p = 0.003), P100 amplitude of pattern visual evoked potential, 1° (AUC 0.84, p = 0.013), wiVD macula superficial (AUC 0.80, p = 0.001), wiVD Disc (AUC 0.74, p = 0.016), GCC (AUC 0.74, p = 0.016) and to distinguish early POAG from the moderate to severe POAG: inferotemporal peripapillary VD (AUC 0.94, p < 0.0001) and focal loss volume of GCC (AUC 0.92, p < 0, 001).ConclusionsOur results demonstrate the importance of measuring the microcirculation parameters in the macular area along with PERGs and PVEPs for the early detection of glaucoma. VD in the inferotemporal sector of the peripapillary retina and focal loss volume of the GCC are important for monitoring of the disease. The inclusion of OCTA, PERGs and PVEPs in glaucoma diagnostics may improve its early detection and monitoring.
Highlights
For several decades, there has been a debate on which parameters–structural or functional–are of the highest diagnostic value in glaucoma [1]
Our results demonstrate the importance of measuring the microcirculation parameters in the macular area along with pattern electroretinogram (PERG) and pattern visual evoked potential (PVEP) for the early detection of glaucoma
vessel density (VD) in the inferotemporal sector of the peripapillary retina and focal loss volume of the ganglion cell complex (GCC) are important for monitoring of the disease
Summary
There has been a debate on which parameters–structural or functional–are of the highest diagnostic value in glaucoma [1]. The peripapillary retinal nerve fiber layer and the macular ganglion cell layer appear the most attractive structural markers for glaucoma diagnosis [2]. Some authors emphasized that the macular parameters had high discriminating power and high reproducibility for early glaucoma detection in comparison with the peripapillary retinal nerve fiber layer (RNFL) parameters [3]. Our recent studies have shown that the circulatory parameters can serve as the diagnostic markers of glaucoma [4]. Some authors have found that color Doppler imaging may have the predictive value for the visual function damage in glaucoma subjects [11,12]
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