Harsha L Rao1, Shruthi Sreenivasaiah2, Mohammed Riyazuddin3, Srilakshmi Dasari3, Shivani Dixit2, Jayasree P Venugopal2, Zia S Pradhan2, Narendra K Puttaiah4, Sathi Devi2, Robert N Weinreb5, Kaweh Mansouri6, Carroll A B Webers7. 1. Narayana Nethralaya, Rajajinagar, Bangalore, India; Narayana Nethralaya, Hulimavu, Bangalore, India. Electronic address: harshalaxmanarao@gmail.com. 2. Narayana Nethralaya, Rajajinagar, Bangalore, India. 3. Narayana Nethralaya, Hulimavu, Bangalore, India. 4. Narayana Nethralaya, Rajajinagar, Bangalore, India; Narayana Nethralaya, Hulimavu, Bangalore, India. 5. Shiley Eye Institute, Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA. 6. Glaucoma Center, Montchoisi Clinic, Swiss Vision Network, Lausanne, Switzerland; Department of Ophthalmology, University of Colorado, Denver, Colorado, USA. 7. University Eye Clinic Maastricht, University Medical Center, Maastricht, Netherlands.
Abstract
PURPOSE: To determine the prevalence and factors associated with the presence of choroidal microvascular dropout (CMvD) in primary angle-closure glaucoma (PACG) eyes compared to primary open-angle glaucoma (POAG) eyes. DESIGN: Cross-sectional study. METHODS: Thirty-six POAG eyes (36 patients) and 28 PACG eyes (28 patients) underwent optical coherence tomography angiography (OCTA). Presence of CMvD was evaluated on choroidal OCTA slabs. Visual field (VF) defects in the glaucoma eyes were classified into initial nasal defect (IND), initial parafoveal scotoma (IPFS), and combined nasal and parafoveal defect, and the association between type of VF defect and CMvD was evaluated. RESULTS: CMvD was detected in 21 POAG (58.3%) and 10 PACG (35.7%) eyes (P = .07). CMvD in POAG eyes was associated with pretreatment intraocular pressure (odds ratio [OR] = 0.91/mm Hg higher intraocular pressure, P = .06), VF mean deviation (MD, OR = 0.75/dB higher MD, P = .007), retinal nerve fiber layer thickness (OR = 0.92/μm increase in thickness, P = .02), and peripapillary vessel density (OR = 0.80/unit increase in density, P = .01). CMvD in PACG eyes was associated only with VF MD (OR = 0.90/dB higher MD, P = .05). When analyzed in the entire cohort of glaucoma patients (64 eyes), CMvD was significantly associated with POAG (OR > 3.5, P < .05) after accounting for glaucoma severity. CMvD was seen in 6 of 7 eyes with IPFS and 1 of 13 with IND in the POAG group (P < .05) and 1 of 2 eyes with IPFS and 0 of 10 with IND in the PACG group (P < .05). CONCLUSIONS: Prevalence of CMvD was significantly lower in PACG compared to POAG. As in POAG, CMvD in PACG was associated with advanced VF damage and with IPFS on VF.
PURPOSE: To determine the prevalence and factors associated with the presence of choroidal microvascular dropout (CMvD) in primary angle-closure glaucoma (PACG) eyes compared to primary open-angle glaucoma (POAG) eyes. DESIGN: Cross-sectional study. METHODS: Thirty-six POAG eyes (36 patients) and 28 PACG eyes (28 patients) underwent optical coherence tomography angiography (OCTA). Presence of CMvD was evaluated on choroidal OCTA slabs. Visual field (VF) defects in the glaucoma eyes were classified into initial nasal defect (IND), initial parafoveal scotoma (IPFS), and combined nasal and parafoveal defect, and the association between type of VF defect and CMvD was evaluated. RESULTS: CMvD was detected in 21 POAG (58.3%) and 10 PACG (35.7%) eyes (P = .07). CMvD in POAG eyes was associated with pretreatment intraocular pressure (odds ratio [OR] = 0.91/mm Hg higher intraocular pressure, P = .06), VF mean deviation (MD, OR = 0.75/dB higher MD, P = .007), retinal nerve fiber layer thickness (OR = 0.92/μm increase in thickness, P = .02), and peripapillary vessel density (OR = 0.80/unit increase in density, P = .01). CMvD in PACG eyes was associated only with VF MD (OR = 0.90/dB higher MD, P = .05). When analyzed in the entire cohort of glaucomapatients (64 eyes), CMvD was significantly associated with POAG (OR > 3.5, P < .05) after accounting for glaucoma severity. CMvD was seen in 6 of 7 eyes with IPFS and 1 of 13 with IND in the POAG group (P < .05) and 1 of 2 eyes with IPFS and 0 of 10 with IND in the PACG group (P < .05). CONCLUSIONS: Prevalence of CMvD was significantly lower in PACG compared to POAG. As in POAG, CMvD in PACG was associated with advanced VF damage and with IPFS on VF.
Authors: Harsha L Rao; Zia S Pradhan; Min Hee Suh; Sasan Moghimi; Kaweh Mansouri; Robert N Weinreb Journal: J Glaucoma Date: 2020-04 Impact factor: 2.290
Authors: Zia S Pradhan; Harsha L Rao; Shivani Dixit; Shruthi Sreenivasaiah; Praveena G Reddy; Jayasree P Venugopal; Narendra K Puttaiah; Sathi Devi; Robert N Weinreb; Kaweh Mansouri; Carroll A B Webers Journal: Invest Ophthalmol Vis Sci Date: 2019-05-01 Impact factor: 4.799