Assessment of Perfused Peripapillary Capillaries and Peripapillary Capillary Density Maps in Glaucoma Patients

Abstract

Introduction: Monitoring and diagnosing glaucoma until 2017 included funduscopy, IOP measurements, gonioscopy, pachymetry, as well as visual field tests, optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A). Radial peripapillary capillaries (RPC) can be observed by fluorescein angiography, as well as histologically - superficial and deep capillary layer. Aim: To correlate density of radial peripapillary capillary network (RPC) and retinal nerve fiber layer (RNFL) thickness in eight peripapillary segments in patients with a primary open angle glaucoma (POAG) which have the disease under 10 years of duration, over 10 years of duration and in a group of healthy patients. Methods: This is a cross-sectional review which included three groups of patients: POAG patients under 10 years of disease duration, over 10 years of disease duration and control group of patients. The study is performed on the commercial optical coherence tomography angiography system (AngioVue, Avanti RTVue-XR, Optovue, CA). Sectoral RPC density values, RPC maps and RNFL thickness were analyzed in three groups of patients, data was compared and correlation between parameters was examined. Results: Mean RPC Density values in both superior segments (S1, S2) were significantly lower in patients with glaucoma over 10 years of disease duration compared to patients with glaucoma under 10 years of disease duration (p<0.05). Statistically significant positive correlation was established between RNFL thickness and RPC density in all eight peripapillary segments. Conclusion: Analysis of radial peripapillary capillary network density on optical coherence tomography angiography may provide an earliest functional sign of progressive optic nerve disease and new insights into the pathophysiology of glaucomatous damage.

Changes of Peripapillary Capillary Density in Patients with Vogt–Koyanagi–Harada Disease Evaluated by Optical Coherence Tomography Angiography

“…In healthy subjects, the average RPC plexus density was positively correlated with the average thickness of the RNFL [ 21 , 22 ], indicating that the RPC plexus supplies the RNFL around the optic nerve head [ 23 ]. Prior studies have also reported decreases in RPC density in patients with glaucoma, Fuch's syndrome, and nonarteritic anterior ischemic optic neuropathy, all of which are characterized by visual field defects [ 24 – 26 ]. In some case reports, VKH disease with optic disc swelling was accompanied by anterior ischemic optic neuropathy (AION), resulting in a reduced RNFL thickness and visual field defects, but AION was not found in patients with VKH disease without optic disc swelling [ 27 , 28 ].…”

Potency of SARS-CoV-2 on Ocular Tissues

“…Decrease in radial peripapillary capillary plexus density and nerve fiber layer thinning have been characterized in patients with early stage of glaucoma [117,118]. Besides, it is more prominent in patients with glaucoma for more than ten years than in patients with glaucoma less than ten years [119]. However, whether the peripapillary capillary changes in patients with COVID-19 are reversible will be seen in further studies.…”