Diagnostic ability and sectoral structure–function relationship of circumpapillary and macular superficial vessel density in early glaucomatous eyes

Akiyama, Kaho; Saito, Hitomi; Shirato, Shiroaki; Iwase, Aiko; Sugimoto, Katsuhisa; Fujishiro, Takashi; Murata, Hiroshi; Sakata, Rei; Honjo, Megumi; Aihara, Makoto

doi:10.1038/s41598-022-10033-1

Cited by 7 publications

(12 citation statements)

References 34 publications

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“…In support of wider field analysis, Akiyama et al reported that in early glaucoma eyes, a perifoveal annulus around the foveal avascular zone (with outer limits of 6 mm and inner of 3 mm) had a stronger structure-function relationship with VF than a smaller parafoveal annulus (outer limits of 3 mm, inner of 1 mm). 37 The current study's scan size could still be considered a limitation in that wider-field images were not obtained, which may have increased wedge identification, and the ability to quantify a larger proportion of wedge defects, however, this would have further reduced resolution and observable detail. Therefore, scan size and the analysis rigour must be noted when comparing results across studies.…”

Section: Discussionmentioning

confidence: 95%

“…Previous studies often analyse the 3 × 3 mm scan which has a greater resolution than the 6 × 6 mm (cohort one) and 8.7 × 4.4 mm (cohort two) scans however, larger scan area was chosen to best visualise vascular wedge projection, despite the increase in capillary network detail from smaller scans which may influence overall density results. In support of wider field analysis, Akiyama et al reported that in early glaucoma eyes, a perifoveal annulus around the foveal avascular zone (with outer limits of 6 mm and inner of 3 mm) had a stronger structure–function relationship with VF than a smaller parafoveal annulus (outer limits of 3 mm, inner of 1 mm) 37 . The current study's scan size could still be considered a limitation in that wider‐field images were not obtained, which may have increased wedge identification, and the ability to quantify a larger proportion of wedge defects, however, this would have further reduced resolution and observable detail.…”

Section: Discussionmentioning

confidence: 95%

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Quantification of localised vascular wedge‐shaped defects in glaucoma

Saks,

Schulz,

Sheriff

et al. 2022

Clinical Exper Ophthalmology

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Background Vascular dysfunction plays a considerable role in glaucoma pathogenesis. Previous glaucoma case studies described localised wedge‐shaped vascular defects, similar to retinal nerve fibre layer (RNFL) wedge defects. This study investigates the prevalence and quantification of this vessel loss, in relation to primary open angle glaucoma (POAG) parameters. Methods This study included 608 eyes (351 participants): 192 PROGRESSA study participants (342 eyes) with suspect, preperimetric or early manifest POAG, observed for vascular wedge defect presence (cohort one); an additional 114 individuals (cohort two—208 eyes) with POAG at various stages of progression for wedge characterisation; and 38 controls (56 eyes). Vascular wedge defects were observed using optical coherence tomography angiography (OCTA). Wedge parameters and vessel densities were quantified using ImageJ software. RNFL and ganglion cell layer inner plexiform layer (GCLIPL) from OCT scans, and mean deviation (Humphrey visual field 24–2) were also assessed. Results Vascular wedge defects were found in 45/342 eyes (13.2%) in cohort one, in 41/208 eyes (19.7%) in cohort two and were not found in controls. Wedge defects were mostly inferotemporal (80%), and present at all disease stages. They were associated with visual field loss in the opposite hemisphere, thinner RNFL (p < 0.001), thinner GCLIPL (p = 0.003), and focal RNFL loss corresponding with the vascular defect region. Conclusion Vascular wedge defects are present at all POAG stages even before functional change and are strongly concordant with focal RNFL loss. Further research is needed to explore these defects in particular their temporal relationship with clinical measures of POAG.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Quantification of localised vascular wedge‐shaped defects in glaucoma

Saks,

Schulz,

Sheriff

et al. 2022

Clinical Exper Ophthalmology

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“…OCT and OCT angiography examinations were performed using the Cirrus HD 5000 OCT and the AngioPlex software (Version 11.0.0.29946; Carl Zeiss Meditec Inc.). The scanning speed was 68,000 A-scans per speed 42,43 . After pupil dilation with tropicamide and phenylephrine hydrochloride, high-quality circumpapillary OCT and OCT angiography scans were acquired by a trained operator in the same session, and the image with the best image quality was selected for subsequent analyses.…”

Section: Oct and Oct Angiography Measurementsmentioning

confidence: 99%

“…The Optic Disc Cube 200 × 200 scan protocol was used for cpRNFLT measurement 42,43 . Tracking of eye movements (Fast Trac) was applied during image acquisition.…”

Section: Oct and Oct Angiography Measurementsmentioning

confidence: 99%

Influence of Refractive Error on Circumpapillary Structure–Function Versus Vessel Density–Function Relationships in Open Angle Glaucoma

Holló

Kita

Saito

et al. 2023

Journal of Glaucoma

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Précis: In Japanese open angle glaucoma (OAG) eyes correlation of 30-degree visual field mean deviation (MD) and visual field index (VFI) with circumpapillary vessel density is systematically stronger than that with circumpapillary retinal nerve fiber layer thickness (RNFLT), and is preserved in myopia and high myopia. Purpose: The purpose of this study was to investigate the influence of refractive error on the relationship between circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and circumpapillary vessel density (cpVD), respectively, and global visual field parameters in Japanese open angle glaucoma (OAG) eyes. Material and Methods: One eye of 81 Japanese OAG patients (spherical equivalent refractive error: +3.0 to −9.0 D) underwent 360-degree cpRNFLT and cpVD measurements with Cirrus HD 5000-AngioPlex optical coherence tomography and 30-2 Humphrey visual field testing for mean deviation (MD) and visual field index (VFI) within 1 month. Correlations were determined for the whole population and each refractive error subgroups, separately: emmetropia/hyperopia (n=24), mild (n=18), moderate (n=20), and high myopia (n=19). Results: For the total population, significant strong to very strong correlations were found between MD, VFI, and both cpRNFLT and cpVD, respectively, with consistently higher r-values for cpVD (highest r-values: 0.532 for cpRNFLT, P<0.001; 0.722 for cpVD, P<0.001). Of the refractive subgroups, statistically significant correlations between cpRNFLT and the visual field parameters were maintained only in the hyperopia/emmetropia and moderate myopia groups. In contrast, statistically significant, strong to very strong correlations between cpVD and both MD and VFI, always exceeding the corresponding r-values found for cpRNFLT were found in all refractive subgroups, with r-values ranging between 0.548 (P=0.005) and 0.841 (P<0.001). Conclusions: Our results suggest that in Japanese OAG eyes the relationship of MD and VFI with cpVD is strong. It is systematically stronger than that with cpRNFLT and preserved in each conventional refractive error category including high myopia.

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“…OCT angiography (OCTA) is one of the most recent technologies which enables noninvasive imaging to quantify layer specific ocular microcirculation of the retina and choroid. Although several studies have shown the usefulness of evaluating circumpapillary vessel density (cpVD) in detecting focal glaucomatous changes of early glaucomatous eyes, 8 little is known about the potential of OCTA in HM eyes. There are reports of cpVD being reduced in HM eyes in comparison to eyes without HM, 9 suggesting the influence of AL elongation on OCTA parameters.…”

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confidence: 99%

Structure Function Relationships of Vessel Density and Retinal Nerve Fiber Layer Thickness in Early Glaucomatous Eyes With High Myopia

Akiyama

Saito

Shirato

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to evaluate the structure function relationship of circumpapillary vessel density (cpVD) with visual field sensitivity (VFS) and compare its characteristics with circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in early glaucomatous (EG) and normal eyes with and without high myopia (HM). Methods Seventy-five EG (mean deviation > −6 dB) and 7 normal eyes with HM (axial length [AL] >26.5 mm) and 111 EG and 11 normal eyes without HM were enrolled in this retrospective cross-sectional study. All patients underwent circumpapillary optical coherence tomography (OCT) and OCT angiography (OCTA) scanning with the Cirrus HD-6000 with AngioPlex OCTA (Carl Zeiss Meditec, Dublin, CA, USA). Structure function correlations were determined by comparing global, superior, inferior, and Garway-Heath sectoral values for cpVD and cpRNFLT with its corresponding 24-2 and 10-2 VFS of Humphrey Visual Field (HFA) analyzer. Results CpVD showed no significant correlations with AL except for the nasal sector ( P = 0.044), whereas cpRNFLT demonstrated significant positive association with AL in the global ( P = 0.024), nasal ( P = 0.020), and temporal ( P < 0.001) sectors. In HM eyes, global and sectoral cpVD significantly correlated with corresponding VFS in all 24-2/10-2 VF sectors (all P < 0.05). CpVD-VFS correlation was significantly stronger than cpRNFLT-VFS in the nasal sector of HM eyes ( P = 0.002) and temporal and inferior temporal sector of eyes without HM ( P = 0.008 and P = 0.042, respectively). Conclusions In EG eyes with HM, cpVD was less affected by AL in comparison to cpRNFLT and cpVD-VFS correlation was significant in all 24-2/10-2 VF sectors. AL-associated advantages of cpVD-VFS over cpRNFLT-VFS were observed.

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Diagnostic ability and sectoral structure–function relationship of circumpapillary and macular superficial vessel density in early glaucomatous eyes

Cited by 7 publications

References 34 publications

Quantification of localised vascular wedge‐shaped defects in glaucoma

Quantification of localised vascular wedge‐shaped defects in glaucoma

Influence of Refractive Error on Circumpapillary Structure–Function Versus Vessel Density–Function Relationships in Open Angle Glaucoma

Structure Function Relationships of Vessel Density and Retinal Nerve Fiber Layer Thickness in Early Glaucomatous Eyes With High Myopia

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