Reduction of Optic Disc Microvasculature and Retinal Nerve Fiber Layer Thinning in Patients With Glaucoma.
Suh Min Hee, Weinreb Robert N, Zangwill Linda M, Walker Evan
AI Summary
This study found that optic disc microvasculature reduction is linked to faster retinal nerve fiber layer thinning in glaucoma, suggesting blood flow plays a role in disease progression.
Abstract
Purpose
To assess the relationship between the change of optic disc vessel density (ODVD) and retinal nerve fiber layer (RNFL) thinning in primary open-angle glaucoma (POAG) patients.
Design
Retrospective case series.
Methods
For 105 POAG patients, ≥5 consecutive optical coherence tomography (OCT) and OCT angiography images were obtained during ≥2 years of follow-up. Based on enface OCT angiography imaging, ODVD was calculated as the ratio of pixels occupied by vessels below the internal limiting membrane within the temporal area of the optic cup, and ODVD reduction was determined when there was a statistically significant negative slope (P < .05) for any of the global, superior, or inferior sectors. The association between the rates of ODVD change and RNFL thinning was assessed by a multivariable longitudinal linear mixed-effects model versus time.
Results
During 2.9 ± 0.3 years of follow-up on the 105 participants with visual field mean deviation at baseline of -5.7 ± 4.8 dB, 46 (43.8%) showed ODVD reduction. Faster global RNFL thinning was associated with the smaller Bruch's membrane opening area (ß = 0.381; 95% confidence interval [CI], 0.120-0.646; P = .006), optic disc hemorrhage (ß = -0.567; 95% CI, -0.909 to -0.228; P = .002), and faster rate of global ODVD change (ß = -0.090; 95% CI, -0.139 to -0.042; P = .001).
Conclusions
Reduction of optic disc microvasculature was associated with rapid RNFL thinning in POAG. This suggests a role for deep optic nerve head circulation in the glaucoma pathogenesis.
MeSH Terms
Shields Classification
Key Concepts5
In a retrospective case series of 105 primary open-angle glaucoma (POAG) patients followed for 2.9 ± 0.3 years, 46 (43.8%) showed optic disc vessel density (ODVD) reduction.
In primary open-angle glaucoma (POAG) patients, faster global retinal nerve fiber layer (RNFL) thinning was associated with a smaller Bruch's membrane opening area (ß = 0.381; 95% confidence interval [CI], 0.120-0.646; P = .006).
In primary open-angle glaucoma (POAG) patients, faster global retinal nerve fiber layer (RNFL) thinning was associated with optic disc hemorrhage (ß = -0.567; 95% confidence interval [CI], -0.909 to -0.228; P = .002).
In primary open-angle glaucoma (POAG) patients, faster global retinal nerve fiber layer (RNFL) thinning was associated with a faster rate of global optic disc vessel density (ODVD) change (ß = -0.090; 95% confidence interval [CI], -0.139 to -0.042; P = .001).
Reduction of optic disc microvasculature was associated with rapid retinal nerve fiber layer (RNFL) thinning in primary open-angle glaucoma (POAG) patients, suggesting a role for deep optic nerve head circulation in glaucoma pathogenesis.
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