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Am J OphthalmolJune 2016203 citations

Microvascular Density in Glaucomatous Eyes With Hemifield Visual Field Defects: An Optical Coherence Tomography Angiography Study.

Akagi Tadamichi, Iida Yuto, Nakanishi Hideo, Terada Noriko, Morooka Satoshi, Yamada Hiroshi, Hasegawa Tomoko, Yokota Satoshi, Yoshikawa Munemitsu, Yoshimura Nagahisa


AI Summary

Glaucoma patients with hemifield visual field defects showed region-specific microvascular reduction in the peripapillary retina and partially in the optic disc, correlating with visual field loss. This suggests microvascular changes contribute to glaucoma progression.

Abstract

Purpose

To investigate microcirculation of peripapillary retina and optic disc in eyes with primary open-angle glaucoma (POAG) and hemifield visual field (VF) defects.

Design

Prospective observational case series with normal comparison group.

Methods

Sixty eyes with POAG (41 with superior and 19 with inferior hemifield VF defects) and 21 normal eyes were included in this study. Optical coherence tomography (OCT) angiography was used to acquire 3 × 3-mm optic disc cubes, and circumpapillary retinal nerve fiber layer thickness was also measured using OCT. Vessel densities in the peripapillary superficial retina and whole-signal-mode optic disc were individually analyzed based on the sectorial division.

Results

The peripapillary vessel densities were significantly reduced at the corresponding location of the VF defects in both non-highly myopic (P < .001, P = .006) and highly myopic glaucomatous eyes (P < .001, P = .005) compared with the normal eyes. Vessel densities of the optic discs were significantly reduced at locations corresponding to the VF defects in eyes without high myopia but with inferior hemifield VF defects (P = .006), but not in the other eyes. The vessel densities in the peripapillary retina were significantly associated with visual field total deviation values at their corresponding sides. The choroidal microvascular reduction in the peripapillary area extended to the α-peripapillary atrophy (PPA) as well as β-PPA zones.

Conclusions

Microvascular reduction was associated with VF defects in a region-specific manner: significantly and partially in the peripapillary retina and optic disc, respectively.


MeSH Terms

AdultAgedAged, 80 and overCase-Control StudiesFemaleFluorescein AngiographyGlaucoma, Open-AngleHumansMaleMicrovesselsMiddle AgedNerve FibersOptic DiskOptic Nerve DiseasesProspective StudiesRetinal Ganglion CellsRetinal VesselsTomography, Optical CoherenceVisual Field TestsVisual Fields

Key Concepts5

The peripapillary vessel densities were significantly reduced at the corresponding location of the visual field defects in both non-highly myopic (P < .001, P = .006) and highly myopic glaucomatous eyes (P < .001, P = .005) compared with normal eyes.

PrognosisCase seriesProspective observational case series with normal comparison groupn=60 eyes with POAG (41 with superior a…Ch5Ch6Ch12

Vessel densities of the optic discs were significantly reduced at locations corresponding to the visual field defects in eyes without high myopia but with inferior hemifield visual field defects (P = .006), but not in the other eyes.

PrognosisCase seriesProspective observational case series with normal comparison groupn=60 eyes with POAG (41 with superior a…Ch5Ch6Ch12

The vessel densities in the peripapillary retina were significantly associated with visual field total deviation values at their corresponding sides in eyes with primary open-angle glaucoma (POAG) and hemifield visual field (VF) defects.

PrognosisCase seriesProspective observational case series with normal comparison groupn=60 eyes with POAG (41 with superior a…Ch5Ch6Ch12

The choroidal microvascular reduction in the peripapillary area extended to the α-peripapillary atrophy (PPA) as well as β-PPA zones in eyes with primary open-angle glaucoma (POAG) and hemifield visual field (VF) defects.

MechanismCase seriesProspective observational case series with normal comparison groupn=60 eyes with POAG (41 with superior a…Ch5Ch12

Microvascular reduction was associated with visual field defects in a region-specific manner: significantly and partially in the peripapillary retina and optic disc, respectively, in eyes with primary open-angle glaucoma (POAG) and hemifield visual field (VF) defects.

PrognosisCase seriesProspective observational case series with normal comparison groupn=60 eyes with POAG (41 with superior a…Ch5Ch6Ch12

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