Choroidal Microvascular Dropout in Primary Angle Closure Glaucoma

Rao, Harsha L.; Sreenivasaiah, Shruthi; Riyazuddin, Mohammed; Dasari, Srilakshmi; Dixit, Shivani; Venugopal, Jayasree P.; Pradhan, Zia S.; Puttaiah, Narendra K.; Devi, Sathi; Weinreb, Robert N.; Mansouri, Kaweh; Webers, Carroll A.B.

doi:10.1016/j.ajo.2018.11.021

Cited by 31 publications

(24 citation statements)

References 33 publications

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“…Firstly, this is a retrospective study with a relatively small sample of 33 subjects. Secondly, we did not examine the deep retinal and choroidal vasculature of our subjects, as those with PACG eyes had decreased VD 41 . Thirdly, all the APAC eyes were examined after fully resolving with medications, but we could not distinguish the influence of medications.…”

Section: Discussionmentioning

confidence: 99%

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Liu

Jiang

et al. 2020

Sci Rep

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This study analyzed the optical coherence tomography angiography (OCTA) macular parameters in primary angle-closure glaucoma (PACG) patients after acute primary angle closure (APAC) episodes. Thirty-three patients with 33 APAC eyes and 33 primary angle closure suspect (PACS) eyes and 33 age-matched normal subjects (controls) were enrolled. Macular vessel density (VD) in central, inner, outer and full regions and foveal avascular zone (FAZ) parameters (area, perimeter and circularity index) were compared between APAC, PACS, and control eyes. For resolved APAC eyes, the VD in each macular region was significantly lower than that in control eyes, with less central and inner macular VD than PACS eyes. The central macular VD was significantly lower in PACS eyes than in controls. There was no difference in FAZ area and perimeter between APAC, PACS, and control eyes. FAZ circularity was highest in control eyes, followed by PACS eyes, and lowest in APAC eyes. The AUC, sensitivity and specificity of FAZ circularity were 0.944, 93.9% and 84.8%, respectively, in APAC eyes and 0.881, 84.8% and 81.8%, respectively, in PACS eyes. Therefore, FAZ circularity had the best discrimination capability for detecting both APAC and PACS eyes. Macular assessment with OCTA could provide an accurate early-stage diagnostic tool for PACG.

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Section: Discussionmentioning

confidence: 99%

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Liu

Jiang

et al. 2020

Sci Rep

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“…Stereoscopic optic disc photographs were evaluated independently by two glaucoma experts in a masked manner to determine the presence of glaucomatous changes as described previously 11,14…”

Section: Methodsmentioning

confidence: 99%

“…The following measurements were obtained from the choroidal OCTA slab using ImageJ software (version 1.51; National Institutes of Health, Bethesda, MD, USA) as described previously:14 optic disc area, area of PPA, CMvD area, and angular extent of CMvD. Optic disc and the PPA margins were marked by simultaneously viewing the stereoscopic optic disc photographs and the scanning laser ophthalmoscopic images that were obtained along with the OCTA images (Figure, panel b).…”

Section: Methodsmentioning

confidence: 99%

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Choroidal Microvascular Dropout in Pseudoexfoliation Glaucoma

Pradhan

Rao

Dixit

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To compare the prevalence of choroidal microvasculature dropout (CMvD) in pseudoexfoliation glaucoma (PXG) and disease severity-matched primary open-angle glaucoma (POAG) eyes. METHODS. In a cross-sectional study, 39 eyes with PXG (33 patients) and 39 glaucoma severitymatched POAG eyes (34 patients) underwent visual fields, optical coherence tomography and optical coherence tomography angiography examination. Peripapillary vessel density (VD) was evaluated from the radial peripapillary capillary slab, parafoveal VD was measured on the superficial vascular plexus slab of the macula, and CMvD was evaluated on the choroidal slabs of the optic disc scan. RESULTS. The PXG and POAG groups were similar with respect to average mean deviation on visual fields (À12.1 vs. À12.0 decibel, P ¼ 0.96) and average peripapillary retinal nerve fiber layer thickness on optical coherence tomography (71 vs. 74 l, P ¼ 0.29). Average peripapillary superficial VD (49.7% vs. 51.3%, P ¼ 0.35) and parafoveal VD (44.8% vs. 45.8%, P ¼ 0.33) were similar between the PXG and POAG groups. CMvD was seen in 18 PXG and 31 POAG eyes (46.2% vs. 79.5%, P ¼ 0.002). On multivariate analysis that accounted for the severity of glaucoma, the odds of CMvD was significantly lower in the PXG group when compared with the POAG group (odds ratio: 0.18-0.21, P < 0.01).

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“…10 In addition, choroidal microvascular dropout in regions of peripapillary atrophy occurs in POAG where it is associated with advanced visual field defects. 14 Our earlier OCT studies showed that horizontal duction deforms ppBM and the superficial ON vasculature. 3,[15][16][17] We have not previously investigated the effect of gaze direction on choroidal volume nor the effect of subject age on such changes.…”

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confidence: 96%

Compression of the Choroid by Horizontal Duction

Chen

Andrade

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The optic nerve becomes tethered in adduction in most people, which deforms the disc. We investigated the effect of horizontal ocular duction and subject age on choroidal volume at the macular side of the optic disc. METHODS.In 25 younger (18-33 years) and 15 older (50-73 years) normal subjects, the disc and the peripapillary choroid were imaged with optical coherence tomography (OCT) in central gaze and 358 adduction and abduction. The choroid temporal to the optic disc underlying the region between the Bruch's membrane opening and fovea was segmented into regions that were multiples of the disc radius for determination of local choroidal thickness. Regional volume changes from central gaze were determined in adduction and abduction. RESULTS.In adduction, regional choroidal volume decreased by 42.4 6 3.4 nanoliters (nL) (standard error of the mean) in younger (P < 0.0001) and 6.2 6 2.6 nL in older (P < 0.02) subjects. Relative volume reduction in adduction was 7.5% 6 0.6% in younger (P < 0.001) and 1.3% 6 0.6% in older (P < 0.02) subjects. Volume reduction was greatest near the disc and significant up to three disc radii from it in younger and 1 radius in older subjects but was insignificant in abduction. CONCLUSIONS.Horizontal duction compresses the temporal peripapillary choroid, more in adduction than in abduction and more in younger than older subjects. This reflects ductionrelated peripapillary tissue deformation probably related, at least in part, to optic nerve tethering in adduction.

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Choroidal Microvascular Dropout in Primary Angle Closure Glaucoma

Cited by 31 publications

References 33 publications

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Choroidal Microvascular Dropout in Pseudoexfoliation Glaucoma

Compression of the Choroid by Horizontal Duction

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