Choroidal Microvascular Dropout in Pseudoexfoliation Glaucoma

Abstract

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).

Magnitude of Diurnal Change in Retinal Vessel Density: Comparison Between Exfoliative Glaucoma and Primary Open-Angle Glaucoma

“…Previous studies have examined patients with XFG and POAG to assess the OCTA-based macular (7,11) and peripapillary (5,12-14) regions individually and together (9,(15)(16)(17)(18). Some of the results are consistent with our current research (11,12,14,17).…”

“…Some of the results are consistent with our current research (11,12,14,17). Several of these studies recorded observations once daily (11)(12)(13)(14)16,18), while a few used multiple observations, ranging from 2 to 5 per day. Considerable reduction in retinal VD in XFG eyes has been reported by some researchers (11)(12)(13), while others did not find a difference between the retinal VD assessments of XFG and POAG eyes (15).…”

Densidade vascular no estágio inicial do glaucoma primário de ângulo aberto e do glaucoma pseudoesfoliativo: estudo comparativo controlado com angiografia por tomografia de coerência óptica

“…The contrast between our results and those of aforementioned studies might result from disease severity discrepancies of the eyes included in the studies; that is, we only enrolled eyes with very early-stage disease. However, a recent study by Pradhan et al, which compared severity-matched 39 eyes with XFG and 39 eyes with POAG, found no significant difference in peripapillary VD (4.5 × 4.5) of the RPC in contradiction to previous studies (28) . Another factor that might explain the difference between the results of these studies and those of our study is the size and resolution of the area captured on OCT-A, which was 3 × 3 mm (higher definition) in our study.…”

Optical coherence tomography angiography in glaucoma

“…Park et al (51) found reduced superficial peripapillary vessel density in the inferonasal and nasal sectors of eyes with XFG compared to POAG. Two recent studies showed that XFG eyes had a similar level of peripapillary and superficial macular vessel densities compared with open angle glaucoma eyes (52,53).…”