Association between peripapillary scleral deformation and choroidal microvascular circulation in glaucoma

Da Young Shin,Hae Young Lopilly Park,Soo Ji Jeon,Chan Kee Park,Eun Kyoung Kim,Kyoung In Jung

doi:10.1038/s41598-019-54882-9

Da Young Shin, Hae Young Lopilly Park + Show 4 more

Open Access

https://doi.org/10.1038/s41598-019-54882-9

Copy DOI

Abstract

Peripapillary vessel density, which is reduced in eyes with glaucoma, has been proposed as a diagnostic tool for the desease and peripapillary choroidal microvasculature dropout(MvD) is considered one of pathophysiological manifestation of glaucomatous damage. However, little is known about the underlying pathogenic mechanism of dropout. According to recent studies, MvD is associated with structural changes in ONH structures. Therefore, we investigated the association between peripapillary scleral deformation and MvD. Data from 62 open-angle glaucoma (OAG) eyes with MvD and 36 eyes without MvD were analyzed in this study. And eyes with MvD were classified into two groups based on location: a juxtapapillary group and a non-juxtapapillary group for further analysis. More eyes with MvD had focal scleral deformation than did those without MvD (64.5% versus 2.8%; P < 0.001). Peripapillary choroidal thickness and focal scleral deformation were significantly associated with MvD. And juxtapapillary group was more associated with focal scleral deformation and coincidental RNFL defects than non-juxtapapillary groups. Peripapillary choroidal MvD was associated with the presence of scleral deformation, especially with juxtapapillary MvD, which was related to corresponding RNFL defects.

Highlights

Peripapillary vessel density, which is reduced in eyes with glaucoma, has been proposed as a diagnostic tool for the desease and peripapillary choroidal microvasculature dropout(MvD) is considered one of pathophysiological manifestation of glaucomatous damage
MvD is associated with structural changes in optic nerve head (ONH) structures including focal laminar cribrosa (LC) defects, thinner choroidal thickness, and beta or gamma peripapillary atrophy (PPA)[4,12,13]
A number of studies suggest that increased mechanical stress on the ONH and peripapillary area during elongation of the globe may lead to compromised peripapillary deep-layer microvasculature in myopic eyes[21,22,23]

Summary

Introduction

Peripapillary vessel density, which is reduced in eyes with glaucoma, has been proposed as a diagnostic tool for the desease and peripapillary choroidal microvasculature dropout(MvD) is considered one of pathophysiological manifestation of glaucomatous damage. Recent studies using optical coherence tomography angiography (OCT-A) have identified peripapillary vessel density around the ONH and localized microvasculature dropout (MvD) in the deep peripapillary choroidal layer round the ONH3–6. MvD is associated with structural changes in ONH structures including focal laminar cribrosa (LC) defects, thinner choroidal thickness, and beta or gamma peripapillary atrophy (PPA)[4,12,13]. Because the radial peripapillary choriocapillaris adjacent to the disc constitute important blood vessels for the ONH, and previous studies have shown that the most vulnerable area for pressure is the junction of the optic disc and sclera with peripapillary scleral thinning[16,17]

Methods

Results

Conclusion