Harsha L Rao1,2, Thanemozhi Srinivasan3, Zia S Pradhan3, Shruthi Sreenivasaiah3, Dhanaraj A S Rao3, Narendra K Puttaiah1, Sathi Devi3, Sasan Moghimi4, Kaweh Mansouri5,6, Carroll A B Webers2, Robert N Weinreb4. 1. Department of Glaucoma, Narayana Nethralaya, Hulimavu. 2. Department of Glaucoma, University Eye Clinic Maastricht, University Medical Center, Maastricht, The Netherlands. 3. Department of Glaucoma, Narayana Nethralaya, Rajajinagar, Bangalore, Karnataka, India. 4. Hamilton Glaucoma Center, Shiley Eye Institute, and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA. 5. Glaucoma Research Center, Montchoisi Clinic, Lausanne, Switzerland. 6. Department of Ophthalmology, University of Colorado, Denver, CO.
Abstract
PRECIS: Lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) on optical coherence tomography angiography (OCTA) were significantly associated with faster rate of mean deviation (MD) decline. PURPOSE: To evaluate the association between OCTA features and prior visual field (VF) progression in primary angle closure glaucoma (PACG). METHODS: In a cross-sectional study, 46 eyes of 31 PACG patients with 5 reliable VF examinations performed over ≥3 years of follow-up underwent OCTA imaging. Effect of clinical (age, sex, number of antiglaucoma medications, mean, and SD of intraocular pressure during follow-up), optical coherence tomography (average retinal nerve fiber layer and ganglion cell complex thickness) and OCTA (whole enface vessel density of disc and macular scan, deep-layer microvascular dropout) parameters on the rate of MD change was evaluated using linear mixed models. RESULTS: Average (±SD) MD of the baseline VF was -7.4±7.3 dB, and rate of MD change was -0.32±0.29 dB/y. Whole enface vessel density of disc and macular scans was 39.5%±8.1% and 38.7%±4.4%, respectively. Microvascular dropout was noted in 33.3% of the eyes. Multivariate mixed models showed that lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) were significantly associated with faster rate of MD decline. Other factors significantly associated with faster progression in multivariate models were older age (coefficient: -0.02, P<0.05) and the presence of systemic hypertension (coefficient: -0.37, P=0.01) and diabetes (coefficient: -0.28, P=0.05). CONCLUSIONS: Lower superficial vessel density measured using OCTA was significantly associated with faster VF progression in PACG. In these eyes, OCTA parameters can serve as biomarker suggestive of past VF progression.
PRECIS: Lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) on optical coherence tomography angiography (OCTA) were significantly associated with faster rate of mean deviation (MD) decline. PURPOSE: To evaluate the association between OCTA features and prior visual field (VF) progression in primary angle closure glaucoma (PACG). METHODS: In a cross-sectional study, 46 eyes of 31 PACG patients with 5 reliable VF examinations performed over ≥3 years of follow-up underwent OCTA imaging. Effect of clinical (age, sex, number of antiglaucoma medications, mean, and SD of intraocular pressure during follow-up), optical coherence tomography (average retinal nerve fiber layer and ganglion cell complex thickness) and OCTA (whole enface vessel density of disc and macular scan, deep-layer microvascular dropout) parameters on the rate of MD change was evaluated using linear mixed models. RESULTS: Average (±SD) MD of the baseline VF was -7.4±7.3 dB, and rate of MD change was -0.32±0.29 dB/y. Whole enface vessel density of disc and macular scans was 39.5%±8.1% and 38.7%±4.4%, respectively. Microvascular dropout was noted in 33.3% of the eyes. Multivariate mixed models showed that lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) were significantly associated with faster rate of MD decline. Other factors significantly associated with faster progression in multivariate models were older age (coefficient: -0.02, P<0.05) and the presence of systemic hypertension (coefficient: -0.37, P=0.01) and diabetes (coefficient: -0.28, P=0.05). CONCLUSIONS: Lower superficial vessel density measured using OCTA was significantly associated with faster VF progression in PACG. In these eyes, OCTA parameters can serve as biomarker suggestive of past VF progression.
Authors: Harsha L Rao; Thanemozhi Srinivasan; Zia S Pradhan; Shruthi Sreenivasaiah; Dhanaraj A S Rao; Narendra K Puttaiah; Sathi Devi; Sasan Moghimi; Kaweh Mansouri; Carroll A B Webers; Robert N Weinreb Journal: J Glaucoma Date: 2021-08-01 Impact factor: 2.290