The Impact of Superficial Vessel Density on Glaucoma Progression according to the Stage of Glaucoma.

Jiyun Lee,Hae-Young Lopilly Park,Chan Kee Park

doi:10.3390/jcm10215150

Jiyun Lee, Hae-Young Lopilly Park + Show 1 more

Open Access

https://doi.org/10.3390/jcm10215150

Copy DOI

Abstract

Purpose: To investigate the clinical significance of vessel density (VD) on visual field (VF) progression regarding the severity of glaucoma. Methods: A total of 130 eyes were recruited in this retrospective and longitudinal study. Superficial and deep VDs in circumpapillary and macular regions were measured via ImageJ. The rate of VF progression was defined as the mean deviation (MD) slope (dB/year). Linear regression was used to verify factors affecting deterioration of VF. The eyes with lower superficial VD were further analyzed. Results: Fifty patients with early glaucoma (EG) (MD > −6 dB) and 52 patients with moderate-to-advanced glaucoma (MAG) (MD ≤ −6 dB) were included. A faster progression rate was found in MAG (p = 0.049). Superficial VD was noticeably related to the VF progression rate in total eyes and in MAG (Both Ps ≤ 0.007, respectively). With patients in the lower half of the superficial VD, the VD was significantly associated with the rate of progression (B, 0.049, p = 0.021). This association was independent of the baseline MD and OCT parameters. Conclusion: Decreased superficial VD might conversely affect the progression of glaucoma even in MAG, which suggests superficial VD could be used as a potential marker to foresee the disease progression even in progressed eyes.

Highlights

Glaucoma, a progressive optic neuropathy due to irreversible structural damages in optic nerve head (ONH), has been a leading cause of blindness worldwide [1]
Unlike previous reports, we investigated the clinical significance of vessel density (VD) on visual field (VF) progression by laser-focusing on their relationship according to glaucomatous stage, and by further analyzing the relationship between eyes with baseline VD in the upper and lower half and its impact on VF progression
We found that circumpapillary superficial VD was one of the factors consistently associated with VF progression in glaucomatous eyes, in eyes with moderate-to-advanced glaucoma (MAG)

Summary

Introduction

A progressive optic neuropathy due to irreversible structural damages in optic nerve head (ONH), has been a leading cause of blindness worldwide [1]. Efforts have been made to find a valuable parameter of predicting further worsening of glaucoma. In line with these efforts, optical coherence tomography (OCT) and standard automated perimetry (SAP) have played essential roles as standard tools for detecting and monitoring glaucoma [2,3,4,5,6]. In advanced glaucoma, OCT has been considered incapable of and inadequate for tracking structural changes in ONH due to the floor effect [7,8,9,10]. Optical coherence tomography angiography (OTCA) proved its competency as a diagnostic tool [13,14], and its better association with

Methods

Results

Conclusion