Topographic correlation between juxtapapillary choroidal thickness and parapapillary deep-layer microvasculature dropout in primary open-angle glaucoma

Citation: Jo YH, Kwon J, Shon K, Jeong D, Kook MS. Greater severity of glaucomatous damage in eyes with than without choroidal microvasculature dropout in open-angle glaucoma. Invest Ophthalmol Vis Sci. 2019;60:901-912. https://doi.org/ 10.1167/iovs.18-26298 PURPOSE.To assess whether open-angle glaucoma (OAG) eyes with choroidal microvasculature dropout (CMvD) have greater severity of glaucomatous damage compared to those eyes without CMvD. METHODS.In this retrospective case-control study, 80 eyes of 80 OAG patients with visual field (VF) defects confined to a superior hemifield (40 eyes with CMvD and 40 eyes without CMvD matched for age [ 10 years], axial length [ 1 mm], and VF loss [ 1 dB (decibel)]) and 43 healthy eyes were consecutively included. The circumpapillary retinal nerve fiber layer thickness (cpRNFLT), macular ganglion cell-inner plexiform layer thickness (mGCIPLT), circumpapillary vessel density (cpVD), parafoveal VD (pfVD), and VF mean sensitivity (VFMS) were measured. The relationships between CMvD angular extent and structural/VD/ functional measures were assessed at both hemiretinae in OAG eyes with CMvD. Logistic regression analyses were performed to evaluate the associations between significant cpRNFLT reduction at perimetrically intact hemiretinae and relevant clinical variables. RESULTS. Sectoral cpRNFLT and mGCIPLT in the perimetrically intact hemiretinae of eyes withCMvD were significantly lower than those of eyes without CMvD (P < 0.05). There were significant correlations between CMvD angular extent and sectoral measures of structural/ VD/functional parameters at perimetrically intact hemiretinae as well as perimetrically affected hemiretinae in OAG eyes with CMvD. The presence and extent of CMvD had a significant influence on cpRNFLT reduction at perimetrically intact hemiretinae (P < 0.05).CONCLUSIONS. OAG eyes with CMvD showed significantly lower cpRNFLT and mGCIPLT than those without CMvD at the hemiretinae corresponding to intact hemifields, thus requiring more vigilant attention for greater disease severity.

Section: Discussionmentioning

confidence: 99%

Greater Severity of Glaucomatous Damage in Eyes With Than Without Choroidal Microvasculature Dropout in Open-Angle Glaucoma

Kwon

Shon

et al. 2019

“…[28][29][30] On the other hand, given that the study subjects were matched by age and VF MD according to the main purpose of this study (i.e., to evaluate CVI according to MvD_P), the generalizability of the current results to the general population of glaucoma patients might be limited. Given that the pathogenic role of the choroidal structure in the pathogenesis of glaucoma is controversial, 3,[26][27][28][29][30][31][32][33] further studies with large numbers of study subjects are required to better elucidate the relationships among the key factors (i.e., glaucoma severity, choroidal thickness, CVI, and MvD_P).…”

Section: Discussionmentioning

confidence: 99%

Peripapillary Choroidal Vascularity Index in Glaucoma—A Comparison Between Spectral-Domain OCT and OCT Angiography

Park

Suh

Agrawal

et al. 2018

“…3,5,7,8,12,13 Clinical disc margin was defined as an innermost clinically visible hyperreflective border on both the infrared fundus images and OCT. Both βPPA and γPPA were required to have a temporal width ≥100 μm on at least one radial OCT scan image, as measured by the built-in caliper of Spectralis OCT. 3,5,7,12 According to the circumferential extent of the γPPA, the subjects were divided into three groups: (1) eyes without γPPA (no γPPA group) ( Fig. 1A), (2) eyes with γPPA involving the fovea-BM-opening axis with minimum width at the fovea-BM-opening axis of ≥100 μm (conventional γPPA group; Fig.…”

Section: Analysis Of β-Zone Parapapillary Atrophymentioning

confidence: 99%

Characteristics of Focal Gamma Zone Parapapillary Atrophy

Kim

Weinreb

Zangwill

et al. 2020

Citation: Kim HR, Weinreb RN, Zangwill LM, Suh MH. Characteristics of focal gamma zone parapapillary atrophy. Invest Ophthalmol Vis Sci. 2020;61(3):17. https://doi.org/10.1167/iovs.61.3.17 PURPOSE.The purpose of this study was to investigate the characteristics of focal γ-zone parapapillary atrophy (focal γPPA) in patients with primary open-angle glaucoma (POAG) using spectral-domain optical coherence tomography (SD-OCT). METHODS.Three groups of POAG eyes (n = 214) were defined according to the circumferential extent of Bruch's membrane (BM) within the β-zone PPA, as follows: (1) no γPPA (intact BM; n = 81), (2) conventional γPPA (γPPA involving the fovea-BM-opening axis; n = 89), and (3) focal γPPA (γPPA not involving the fovea-BM-opening axis; n = 44). Clinical and ocular characteristics, including age, axial length (AXL), and focal lamina cribrosa (LC) defects were compared among the three groups. RESULTS.The focal γPPA group was significantly older (60.6 ± 11.0 years) and had shorter AXL (24.10 ± 1.34 mm) than those of the conventional γPPA group (46.2 ± 13.8 years and 26.53 ± 1.61 mm, respectively; P < 0.001). These values of the focal γPPA group were similar to those of the no γPPA group (23.73 ± 0.97 mm for AXL and 64.0 ± 13.0 years for age). The focal γPPA group had a significantly higher prevalence of focal LC defects than did the other two groups (70.5% [31/44] for the focal γPPA group versus 46.1% [41/89] for the conventional γPPA group versus 37.0% [30/81] for the no γPPA group; P = 0.002). CONCLUSIONS.Focal γPPA was differentiated from conventional γPPA by older age and shorter AXL. Further, focal γPPA was frequently accompanied by focal LC defects. Longitudinal studies elucidating whether focal LC defects and focal γPPA share common pathogenesis are warranted.