Abstract
PurposeTo evaluate the quantitative characteristics of choroidal thickness in primary open-angle glaucoma (POAG), normal tension glaucoma (NTG) and in normal eyes using spectral-domain optical coherence tomography (SD-OCT). To evaluate the diagnostic ability of choroidal thickness in glaucoma and to determine the correlation between choroidal thickness and visual field parameters in glaucoma.MethodsA total of 116 subjects including 40 POAG, 30 NTG and 46 healthy subjects were enrolled in this study. Choroidal thickness measurements were acquired in the macular and peripapillary regions using SD-OCT. All subjects underwent white-on-white (W/W) and blue-on-yellow (B/Y) visual field tests using Humphrey Field Analyzer. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were generated to assess the discriminating power of choroidal thickness for glaucoma. Pearson’s correlation coefficients were calculated to assess the structure function correlation for glaucoma patients.ResultsNo significant differences were observed for macular choroidal thickness among the different groups (all P > 0.05). Regarding the peripapillary choroidal thickness (PPCT), significant differences were observed among the three groups (all P < 0.05). Post hoc tests for multiple comparisons revealed a significant difference in the NTG-normal comparison group (all P < 0.01). The inferior and temporal PPCT in POAG patients were significantly thinner than those in normal subjects (P = 0.007, P = 0.002, respectively). Different parameters of PPCT showed significantly low diagnostic values to detect POAG from normal subjects (AUC: 0.555 to 0.652) and to discriminate NTG from POAG (AUC: 0.462 to 0.702), but moderate diagnostic power to detect NTG from normal subjects (AUC: 0.708 to 0.771). Regarding the diagnosis of early glaucoma, different parameters of PPCT showed relatively low diagnostic power (AUC: 0.606 to 0.698). In all the glaucoma subjects, PPCT was not significantly correlated with W/W mean deviation (MD) (all P > 0.05), but showed significant correlations with B/Y MD (all P < 0.05). In the early glaucomatous eyes, PPCT showed significant correlations with W/W MD and B/Y MD (all P < 0.05).ConclusionsIn our study, peripapillary choroidal thickness measured on OCT showed a low to moderate but statistically significant diagnostic power and a significant correlation with blue-on-yellow visual field indices in glaucoma. This may indicate a potential adjunct for peripapillary choroidal thickness in glaucoma diagnosis.
Highlights
Glaucoma, the second most common cause of blindness, is a progressive optic neuropathy, characterized by retinal nerve fiber layer (RNFL) defects with subsequent progressive impairment of the visual field
No significant differences were observed for macular choroidal thickness among the different groups
Regarding the peripapillary choroidal thickness (PPCT), significant differences were observed among the three groups
Summary
The second most common cause of blindness, is a progressive optic neuropathy, characterized by retinal nerve fiber layer (RNFL) defects with subsequent progressive impairment of the visual field. Two subtypes are differentiated by the level of intraocular pressure (IOP), primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). The mechanical theory attributes the death of retinal ganglion cells and optic nerve fibers to the high IOP, at least in patients with POAG. The vascular theory attributes the neuropathy to intraneural ischemia resulting from decreased blood supply to the optic nerve at the level of lamina cribrosa. Numerous studies have used Doppler flowmetry to measure choroidal blood flow in POAG and NTG patients, and most have demonstrated reduced choroidal and optic nerve head blood flow [4, 5]
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