Abstract
Purpose: To investigate the applicability of peripapillary non-flow area (PNFA) measurement in the radial peripapillary capillaries (RPC) layer for the measurement of progressive localized glaucomatous perfusion damage.
 Methods: A research soft ware version of the Angiovue /RTVue-XR OCT (Optovue, Fremont, CA, USA) was used to measure localized PNFA progression by clicking on a predefined peripapillary non-perfusion area on prospectively acquired images. Capillary vessel density (VD) in the corresponding peripapillary sector was also measured. High-quality peripapillary Angiovue OCT VD images of an open-angle glaucoma population prospectively imaged for 2 to 2.5 years (5 or 6 visits at 6-month intervals) were investigated. Eyes with both localized PNFA at baseline and statistically significant peripapillary VD progression in the hemifield of the PNFA were selected for the analysis.
 Results: Four eyes of four patients were eligible. In three eyes, the Octopus visual field cluster mean defect in the cluster spatially corresponding to the area of the PNFA progressed significantly (P < 0.01) at a rate of 1.5 to 3.4 dB/year. In two eyes, neither PNFA nor sector VD showed significant correlation with the follow-up time. In one eye, significant negative correlation for sector VD (r = -0.841, P = 0.036) and almost significant positive correlation for PNFA (r = 0.803, P = 0.055) was found, while in another eye significant positive correlation for PFNA (r = 0.875, P = 0.022) but no correlation for sector VD was found.
 Conclusion: Our results suggest that PNFA measurement in the RPC layer is a potentially useful tool for the measurement of progression of localized glaucomatous capillary perfusion damage in open-angle glaucoma eyes with localized peripapillary non-perfusion.
Highlights
Primary open-angle glaucoma is one of the most common, irreversible, and potentially blinding painless progressive optic neuropathies, in which the retinal ganglion cells and their axons are progressively lost.[1]
The most important difference between the information provided by earlier blood flow measurement methods and Optical coherence tomography (OCT) angiography is that the latter provides segmented measurement data for various retinal layers and areas separately, while the former methods provide results for the whole eye, whole optic nerve head, retina, or large retinal areas, respectively
In the current case series, we investigated whether peripapillary non-flow area (PNFA) measurement in the radial peripapillary capillaries (RPC) layer can be used to measure the progression of localized peripapillary capillary perfusion damage in open-angle glaucoma
Summary
Primary open-angle glaucoma is one of the most common, irreversible, and potentially blinding painless progressive optic neuropathies, in which the retinal ganglion cells and their axons are progressively lost.[1]. Optical coherence tomography (OCT) angiography is a non-invasive technology that has been recently developed to measure capillary perfusion in various layers of the retina, in the macula, the optic nerve head, and the peripapillary area, respectively.[6,7,8,9,10] The most important difference between the information provided by earlier blood flow measurement methods and OCT angiography is that the latter provides segmented measurement data for various retinal layers and areas separately, while the former methods provide results for the whole eye, whole optic nerve head, retina, or large retinal areas, respectively. The segmented and localized information offered by OCT angiography on the peripapillary perfusion and its stability or progressive reduction can be coupled with the spatially corresponding structural and functional test results
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