No abstract

PurposeThis study aims to detect peripapillary vascular changes in patients with glaucoma and ocular hypertension compared to healthy eyes, and to correlate these vascular parameters with structural and functional parameters.Methods46 open‐angle glaucoma eyes (GE), 35 ocular hypertension eyes (OHE) and 47 age‐matched control eyes (CE) were analyzed. Visual field test was performed with the Humphrey Field Analyzer 3. Optic disc region was imaged using a 4.5 × 4.5 mm scan by a HD‐OCT Cirrus. Peripapillary perfusion density (PPD) and peripapillary flow index (PFI) were quantified by the owner’s algorithm. The statistical analysis was performed using the Kruskal‐Wallis Test with Bonferroni Post Hoc analysis and Spearman rank correlation.ResultsGE showed an attenuated PPD globally and in each sector compared to OHE and CE (−10.62%), being the superior and inferior sectors the most affected ones. PFI in GE was also lower than those in OHE and CE (−14.43%). PPD and PFI were also lower in OHE than those in CE (p < 0.001 for all pairwise comparisons). Univariate regression analysis showed that PFI was correlated with retinal nerve fiber layer (RNFL) (r = +0.607) and visual field mean deviation (VFMD) (r = +0.586). PPD had a higher correlation with RNFL (r = +0.686) and VFMD (r = +0.609). Superior and inferior sectors were the most correlated (p < 0.001 for all).ConclusionsVascular changes that occur in GE can be visualized as reduced PPD and, specially, as PFI. This finding was not previously described, and suggests that the structural damage may be caused to a greater extent by a decreased PFI more than by an attenuation of PPD. Furthermore, OHE also exhibited vascular abnormalities compared with CE. This indicates that vascular changes may occur before changes in retinal thickness at the early stages of glaucoma. All of these measures resulted to be positively correlated with traditional glaucoma parameters. So, quantitative OCTA may have value in the future to evaluate or follow up glaucoma and ocular hypertension patients.

PurposeTo investigate macular vascular changes in patients with glaucoma and ocular hypertension, and to correlate these vascular parameters with structural and functional outcomes.MethodsA prospective observational study was performed with 46 open‐angle glaucoma eyes (GE), 35 ocular hypertension eyes (OHE) and 47 gender‐ and age‐matched control eyes (CE). Visual field tests were performed with the Humphrey Field Analyzer 3. Angioplex HD‐OCT Cirrus 5000 was used to capture the macular region using a 6 × 6 mm scan. Macular Capillary Perfusion Density (MPD) and Macular Vessel Density (MVD) were automatically quantified by the owner’s microangiography‐complex algorithm. The statistical analysis was performed using the Kruskal‐Wallis Test, Bonferroni Post Hoc analysis and Spearman rank correlation.ResultsMPD and MVD in GE were lower than those in OHE and CE (−37.32% and −37.09%), and the superior and inferior sectors were the most affected. In OHE, MPD and MVD were also lower when compared with CE (p < 0.001 for all pairwise comparisons). However, the FAZ was not significantly different between groups (p = 0.054). Regression analysis showed that MVD was moderately correlated with ganglion cell layer (r = +0.424), visual field mean deviation (r = +0.447) and retinal nerve fiber layer (r = +0.468). MPD had similar correlations (r = +0.431; +0.443 and +0.470, respectively). Superior and nasal sectors were the most correlated (p < 0.001 for all).ConclusionsData showed that in GE, vascular changes took place in the macular area, concretely MPD and MVD measurements were similarly reduced. This finding was not previously described and suggests that the vascular damage of the macular area may occur concurrently among large vessels and smaller capillaries. OHE measurements were also lower compared with CE, and this suggests that, at initial phases of the disease, vascular abnormalities may occur before structural damage can be detected. As MPD and MVD showed to be correlated with traditional glaucoma parameters, OCTA may be useful in the future to monitor glaucoma patients. Nevertheless, further research with larger population is needed to obtain stronger results.

Purpose: To investigate prospectively macular and peripapillary microvascular changes in patients with glaucoma and ocular hypertension. Methods: A 12‐month prospective longitudinal study was performed with 124 open‐angle‐glaucoma‐eyes (GE), 111 ocular‐hypertension‐eyes (OHE) and 98 gender and age matched control‐eyes (CE). Glaucomatous progression was defined as a decrease of ≥5 μm in average or ≥7 μm in a sector of RNFL thickness. OMAG OCT microangiography (Angioplex, HD OCT, Cirrus 5000, Zeiss) was used to analyse optic disc and macular regions. The statistical analysis was performed using Mann–Whitney‐Test with the SPSS version 23.0 statistical package (SPSS Inc., IL). Results: Among OHE and GE groups, 21.7% of eyes showed progression, being the decrease of Peripapillary Flux Index (PFI), Macular Vessel Density (MVD) and Macular Capillary Perfusion Density (MPD) greater (−0.0067; −0.696 mm/mm2 and −1.56%) compared to non‐progressive eyes (+0.0038; 0.527 mm/mm2 and 1.55%) being the nasal and inferior sectors for PFI, and the superior and temporal sectors for both MVD and MPD, the ones that showed greater differences [p = 0.015 and p < 0.001 for the last two]. Furthermore, Peripapillary Perfusion Density (PPD) showed non‐significant greater decrease (−0.347) compared to non‐progressive eyes (−0.324) [p = 0.775]. Characteristics as increased vertical cup to disc ratio (CDV) (0.64 vs. 0.57), elevated intraocular pressure (IOP) (18.25 vs. 15.40 mmHg), thinner central corneal thickness (CCT) (520.18 vs. 541.67 μm) and lower ocular perfusion pressure (OPP) (47.81 vs. 48.95 mmHg) were significantly different in those progressive OHE and GE [p < 0.05 for all]. Nevertheless, minimum ganglion cell layer thickness (GCLM) was only significantly lower in progressive GE (58.51 vs. 73.98 μm) [p = 0.036]. Conclusions: Data showed that when glaucomatous progression took place, stronger microvascular changes occurred in the macular and peripapillary areas, as greater decrease of MVD, MPD and PFI, especially in superior and temporal sectors for the macular area, and in nasal and inferior sectors for the peripapillary area. Nevertheless, further research with larger population and larger follow‐up is needed to obtain stronger results.

No abstract