Automated Evaluation of Parapapillary Choroidal Microvasculature in Ischemic Optic Neuropathy and Open Angle Glaucoma

Abstract

Citation: Aghsaei Fard M, Salabati M, Mahmoudzadeh R, et al. Automated evaluation of parapapillary choroidal microvasculature in ischemic optic neuropathy and open angle glaucoma. Invest Ophthalmol Vis Sci. 2020;61(3):35. https://doi.org/10.1167/iovs.61.3.35 PURPOSE.To determine whether parapapillary choroidal microvasculature (PPCMv) density as measured by optical coherence tomography angiography differs between nonarteritic anterior ischemic optic neuropathy (NAION) and primary open angle glaucoma (POAG). METHODS.Thirty-seven eyes with chronic NAION, 34 unaffected fellow eyes with NAION, 47 moderate and severe POAG eyes, and 54 healthy control subjects were evaluated. Automated PPCMv density was calculated using custom Matlab software in inner and outer annuli around the optic nerve region in addition to peripapillary superficial retinal vessels. RESULTS.Linear models showed no difference in peripapillary retinal nerve fiber layer between NAION and POAG eyes. Mean peripapillary superficial small vessels in the NAION and POAG groups were 36.62 ± 7.1% and 39.72 ± 8.18% without a statistically difference between them (P = 0.16). Mean inner and outer annular region PPCMv densities in the NAION group were 26.55 ± 9.2% and 17.81 ± 6.9%, which were not different from unaffected fellow eyes and the control group. However, the POAG group had significantly reduced PPCMv density in both inner and outer annuli with values of 15.84 ± 6.5% and 12.80 ± 5.0%, respectively, compared with normal subjects (both P < 0.001). Inner and outer circle PPCMv densities were also significantly reduced in the POAG group compared with the NAION group. CONCLUSIONS. ReducedPPCMv density in POAG eyes shows that deep optic nerve head ocular blood flow may contribute to axonal damage in patients with glaucoma.

Clinical characteristics of choroidal microvasculature dropout in normal-tension glaucoma versus nonarteritic anterior ischemic optic neuropathy: an optical coherence tomography angiography study

“…However, despite the discrepancy in CMvD characteristics between NAION and NTG eyes, there was no significant difference in the choroidal VD within the β-PPA between them. Our results differed from those of Fard et al, who reported that choroidal VD was significantly reduced in eyes with primary open-angle glaucoma compared to eyes with NAION but that it did not differ significantly between NAION and healthy control eyes 29 . This discrepancy may be explained by differences in study design and methodology for measuring choroidal VD.…”

Comparative Topographical Analysis of Choroidal Microvascular Dropout Between Glaucoma and Nonarteritic Anterior Ischemic Optic Neuropathy

“… 41 – 43 In the choroid, a different involvement pattern has been questioned. 44 Our hypothesis may conceptually connect the retina and the choroid.…”

Efficacy and Predictive Factors of Oral Spironolactone Treatment in Chronic Central Serous Chorioretinopathy

“…To avoid the shadowing effect of neurosensory detachment that affects the OCTA flow signal in the choriocapillaris, we applied the CCD of a fellow eye for analysis [ 12 ]. Previously developed and validated custom MATLAB software (MathWorks, Inc., Natick, MA, USA) was used to process and analyze these OCTA images or en face images [ 13 , 14 ]. In brief, the density algorithm included three key steps: constructing the binary location of large retinal vessel shadows; capillary segmentation using the modified Otsu algorithm; and calculating the density values of the choroidal vasculature.…”