Long-term optic nerve head microvascular impairment after acute primary angle closure: an OCTA study.
Ying Yue, Fan Xintong, Sun Yanan, Sheng Qilian, Kwan Ye Lin, Hao Mengrui, Kong Xiangmei
AI Summary
APAC causes persistent peripapillary vessel density reduction years later, indicating sustained optic nerve head microvascular impairment. This suggests a mechanism for progressive optic neuropathy despite successful angle opening, highlighting the need for long-term monitoring.
Abstract
Purpose
While previous studies documented transient reductions in fundus vessel density (VD) following acute primary angle closure (APAC), we investigated whether optic nerve head (ONH) and macular VD was lower long-term following APAC. The study aimed to describe long-term microvascular patterns after APAC and identify anatomical regions showing lower VD.
Methods
Resolved APAC, primary angle closure suspects (PACS), and age-sex-matched healthy controls were enrolled. Quantitative microvascular assessment was performed using spectral domain optical coherence tomography angiography (OCTA) system (RTvue XR Avanti; Optovue, Fremont, CA, USA), with 4.5*4.5 mm ONH and 3.0*3.0 mm macular scan protocols. Peripapillary VD was analyzed as the primary endpoint, while sectoral ONH VD and macular VD were evaluated as secondary measures.
Results
The median and range of interval between APAC onset and examination was 15, (1, 60) months. APAC eyes demonstrated marked reduction in peripapillary VD compared with PACS and controls. Macular VD was less affected. ONH VD positively correlated with structural parameters in APAC eyes.
Conclusion
Despite clinical resolution of APAC, peripapillary VD was lower in eyes with previous APAC compared with PACS and controls.
MeSH Terms
Key Concepts5
Eyes with previous acute primary angle closure (APAC) demonstrated marked reduction in peripapillary vessel density (VD) compared with primary angle closure suspects (PACS) and age-sex-matched healthy controls.
Macular vessel density (VD) was less affected in eyes with previous acute primary angle closure (APAC) compared to peripapillary VD.
Optic nerve head (ONH) vessel density (VD) positively correlated with structural parameters in eyes with previous acute primary angle closure (APAC).
Quantitative microvascular assessment was performed using spectral domain optical coherence tomography angiography (OCTA) system (RTvue XR Avanti; Optovue, Fremont, CA, USA), with 4.5*4.5 mm ONH and 3.0*3.0 mm macular scan protocols.
The median and range of interval between APAC onset and examination was 15 (1, 60) months in eyes with previous acute primary angle closure (APAC).
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