Abstract
PurposeTo evaluate the correlation between retinal sensitivity in microperimetry (MP) with vessel density (VD) using optical coherence tomography angiography (OCTA) in primary open-angle glaucoma (POAG).MethodsWe enrolled 30 participants (52 eyes) with POAG and 15 participants (23 eyes) in the healthy control group. All participants were examined for retinal structure using OCTA to assess VD and Spectral domain OCT (SD-OCT) to assess ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness. Retinal sensitivity was tested with MP and standard automatic perimetry (SAP).ResultsThe VD in moderate/severe POAG was lower than that in mild POAG and healthy control in the macular superficial vascular plexus (SVP) (38.7±6.3% vs. 42.9±5.2%, 49.7±2.6% respectively, P<0.001) and peripapillary radial peripapillary capillaries (pRPC) (36.4±5.7% vs. 43.6±6.6%, 49.1±2.4% respectively, P<0.001). The Pearson’s correlations between function-structure parameters were strongest with MP average sensitivity threshold and SVP VD in the area of whole macula (r = 0.68); followed by SAP mean deviation (MD) and pRNFL thickness (r = 0.63); SAP MD and pRPC VD (r = 0.59) and MP average threshold and GCC thickness (r = 0.54). We found the AUROCs for discriminating between glaucomatous and healthy eyes were highest for structural parameters as follows: pRNFL (0.94), macular SVP whole (0.92), pRPC (0.92) and GCC (0.91). Pairwise comparison of the above parameters showed no difference (P>0.05).ConclusionThe relationship between microvascular damage in the macular SVP whole and the decrease of MP average sensitivity threshold is stronger than the pRNFL thickness measurements and SAP parameters. OCTA and MP techniques are valuable methods that allow clinically monitor structural and functional changes in glaucomatous eyes.
Highlights
Primary open angle-glaucoma (POAG) is a progressive optic neuropathy of the optic nerve characterized by retinal ganglion cell (RGC) apoptosis [1]
The vascular density (VD) in moderate/severe POAG was lower than that in mild POAG and healthy control in the macular superficial vascular plexus (SVP) (38.7±6.3% vs. 42.9±5.2%, 49.7±2.6% respectively, P
The relationship between microvascular damage in the macular SVP whole and the decrease of MP average sensitivity threshold is stronger than the peripapillary retinal nerve fiber layer (pRNFL) thickness measurements and standard automatic perimetry (SAP) parameters
Summary
Primary open angle-glaucoma (POAG) is a progressive optic neuropathy of the optic nerve characterized by retinal ganglion cell (RGC) apoptosis [1]. Increasing evidence indicates that abnormalities in retinal microcirculation and impairment of ocular blood flow have significant impact on development of POAG, but the exact role of vascular disorders in the pathogenesis of glaucoma has not been established [2,3,4]. The reduction of retinal vascular density (VD) within the macula and optic nerve head (ONH) has been repeatedly confirmed in patients with POAG [7,8,9,10,11]. Among the overall macular parameters, the SVP VD had the best diagnostic accuracy and was highly correlated with the corresponding retinal ganglion cell complex (GCC) thickness and visual filed (VF) sensitivity [12]
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