Choroidal Structural and Vascular Changes in Early Primary Angle Closure Glaucoma.

PrÉcis: Thicker CT and higher CVI in the 1-12 mm circumferential annular area were noted in early PACG patients compared with healthy controls. More importantly, CVI may serve as a more sensitive indicator for disease progression.

Purpose

To investigate changes of choroidal thickness (CT) and choroidal vascularity index (CVI) in eyes with early primary angle closure glaucoma (PACG) based on swept source optical coherence tomography angiography (SS-OCTA).

Methods

A total of 86 early PACG patients (86 eyes) and 79 healthy individuals (79 eyes) were enrolled. All subjects underwent 12×12 mm macular scan and 6×6 mm optic disc scan to analyze and compare CT and CVI. Univariate and multivariate linear regression analyses were used to evaluate the relevance of CT and CVI to related factors.

Results

In all macular regions, patients with early PACG exhibited thicker CT and higher CVI as compared with healthy controls (all P <0.05). Multivariate linear regression analysis showed that increased subfoveal CT and CVI were associated with younger age, PACG diagnosis, and/or shorter axial length (all P <0.05). After adjusting for the compound factors of age and/or axial length, subfoveal CT and CVI remained significantly higher in patients with early PACG than in healthy controls (both P <0.01). In the peripapillary regions, the mean CT in early PACG patients in the inferior nasal and inferior temporal regions was thicker than that of the healthy controls (both P <0.05).

Conclusion

Early PACG patients are usually associated with thicker CT and higher CVI in 1-12 mm annular regions of the macula. The changes in CT and CVI were independent of age and axial length, indicating that alterations in choroidal characteristics may contribute to the pathogenesis of PACG.