Ji Min Kwon1, Robert N Weinreb2, Linda M Zangwill2, Min Hee Suh3. 1. Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. 2. Hamilton Glaucoma Center, Shiley Eye Institute, and the Department of Ophthalmology, University of California San Diego, La Jolla, California, USA. 3. Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. Electronic address: crishuna6@gmail.com.
Abstract
PURPOSE: To evaluate the association between optical coherence tomography angiography (OCT-A)-derived parapapillary deep-layer microvasculature dropout and glaucomatous visual field (VF) progression. DESIGN: Retrospective, cohort study. METHODS: A total of 138 eyes of 138 patients with primary open-angle glaucoma (mean follow-up, 5.5 years) and with ≥5 VFs prior to OCT-A imaging were included. VF progression was defined as either a Guided Progression Analysis-based "likely progression" event or a significant VF index (VFI) slope. Microvasculature dropout was defined as parapapillary deep-layer microvasculature dropout based on a qualitative analysis of OCT-A. Prevalence of dropout was compared between eyes with and without VF progression. RESULTS: Fifty-five eyes (39.9%) demonstrated VF progression. A higher proportion of eyes with dropout progressed than those without dropout (50/84 eyes [59.5%] vs 5/54 eyes [9.3%]; P < .001). In multivariable logistic regression analysis, mean and standard deviation intraocular pressure, optic disc hemorrhage, focal lamina cribrosa defect, and dropout were significantly associated with prior VF progression (P < .05). The VFI progression rate was significantly faster in eyes with dropout than in those without dropout (-2.23% ± 3.22%/year vs -0.05% ± 1.24%/year, respectively; P < .001), and the location of dropout and VF progression were spatially correlated. CONCLUSIONS: Eyes with parapapillary deep-layer microvasculature dropout detected by OCT-A had a significantly higher rate of VF progression than eyes without dropout. These findings implicate dropout as a structural parameter suggestive of past glaucomatous VF progression. Further prospective longitudinal studies are needed to elucidate the role of deep-layer microvasculature damage in the pathogenesis of glaucoma.
PURPOSE: To evaluate the association between optical coherence tomography angiography (OCT-A)-derived parapapillary deep-layer microvasculature dropout and glaucomatous visual field (VF) progression. DESIGN: Retrospective, cohort study. METHODS: A total of 138 eyes of 138 patients with primary open-angle glaucoma (mean follow-up, 5.5 years) and with ≥5 VFs prior to OCT-A imaging were included. VF progression was defined as either a Guided Progression Analysis-based "likely progression" event or a significant VF index (VFI) slope. Microvasculature dropout was defined as parapapillary deep-layer microvasculature dropout based on a qualitative analysis of OCT-A. Prevalence of dropout was compared between eyes with and without VF progression. RESULTS: Fifty-five eyes (39.9%) demonstrated VF progression. A higher proportion of eyes with dropout progressed than those without dropout (50/84 eyes [59.5%] vs 5/54 eyes [9.3%]; P < .001). In multivariable logistic regression analysis, mean and standard deviation intraocular pressure, optic disc hemorrhage, focal lamina cribrosa defect, and dropout were significantly associated with prior VF progression (P < .05). The VFI progression rate was significantly faster in eyes with dropout than in those without dropout (-2.23% ± 3.22%/year vs -0.05% ± 1.24%/year, respectively; P < .001), and the location of dropout and VF progression were spatially correlated. CONCLUSIONS: Eyes with parapapillary deep-layer microvasculature dropout detected by OCT-A had a significantly higher rate of VF progression than eyes without dropout. These findings implicate dropout as a structural parameter suggestive of past glaucomatous VF progression. Further prospective longitudinal studies are needed to elucidate the role of deep-layer microvasculature damage in the pathogenesis of glaucoma.
Authors: Aakriti G Shukla; Portia E Sirinek; C Gustavo De Moraes; Dana M Blumberg; George A Cioffi; Alon Skaat; Christopher A Girkin; Robert N Weinreb; Linda M Zangwill; Donald C Hood; Jeffrey M Liebmann Journal: J Glaucoma Date: 2020-06 Impact factor: 2.503
Authors: Nevin W El-Nimri; Patricia Isabel C Manalastas; Linda M Zangwill; James A Proudfoot; Christopher Bowd; Huiyuan Hou; Sasan Moghimi; Rafaella C Penteado; Jasmin Rezapour; Eren Ekici; Takuhei Shoji; Elham Ghahari; Adeleh Yarmohammadi; Robert N Weinreb Journal: J Glaucoma Date: 2021-06-01 Impact factor: 2.290
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