Choroidal Microvascular Dropout in Primary Angle Closure Glaucoma.
Rao Harsha L, Sreenivasaiah Shruthi, Riyazuddin Mohammed, Dasari Srilakshmi, Dixit Shivani, Venugopal Jayasree P, Pradhan Zia S, Puttaiah Narendra K, Devi Sathi, Weinreb Robert N
AI Summary
This study found choroidal microvascular dropout (CMvD) is less prevalent in PACG than POAG, but in both, it links to advanced visual field damage, especially parafoveal scotomas, implying shared vascular pathology.
Abstract
Purpose
To determine the prevalence and factors associated with the presence of choroidal microvascular dropout (CMvD) in primary angle-closure glaucoma (PACG) eyes compared to primary open-angle glaucoma (POAG) eyes.
Design
Cross-sectional study.
Methods
Thirty-six POAG eyes (36 patients) and 28 PACG eyes (28 patients) underwent optical coherence tomography angiography (OCTA). Presence of CMvD was evaluated on choroidal OCTA slabs. Visual field (VF) defects in the glaucoma eyes were classified into initial nasal defect (IND), initial parafoveal scotoma (IPFS), and combined nasal and parafoveal defect, and the association between type of VF defect and CMvD was evaluated.
Results
CMvD was detected in 21 POAG (58.3%) and 10 PACG (35.7%) eyes (P = .07). CMvD in POAG eyes was associated with pretreatment intraocular pressure (odds ratio [OR] = 0.91/mm Hg higher intraocular pressure, P = .06), VF mean deviation (MD, OR = 0.75/dB higher MD, P = .007), retinal nerve fiber layer thickness (OR = 0.92/μm increase in thickness, P = .02), and peripapillary vessel density (OR = 0.80/unit increase in density, P = .01). CMvD in PACG eyes was associated only with VF MD (OR = 0.90/dB higher MD, P = .05). When analyzed in the entire cohort of glaucoma patients (64 eyes), CMvD was significantly associated with POAG (OR > 3.5, P < .05) after accounting for glaucoma severity. CMvD was seen in 6 of 7 eyes with IPFS and 1 of 13 with IND in the POAG group (P < .05) and 1 of 2 eyes with IPFS and 0 of 10 with IND in the PACG group (P < .05).
Conclusions
Prevalence of CMvD was significantly lower in PACG compared to POAG. As in POAG, CMvD in PACG was associated with advanced VF damage and with IPFS on VF.
MeSH Terms
Shields Classification
Key Concepts6
In a cross-sectional study, choroidal microvascular dropout (CMvD) was detected in 21 (58.3%) of 36 primary open-angle glaucoma (POAG) eyes and in 10 (35.7%) of 28 primary angle-closure glaucoma (PACG) eyes (P = 0.07).
In a cross-sectional study, choroidal microvascular dropout (CMvD) in primary open-angle glaucoma (POAG) eyes was associated with pretreatment intraocular pressure (odds ratio [OR] = 0.91/mm Hg higher intraocular pressure, P = 0.06), visual field mean deviation (MD, OR = 0.75/dB higher MD, P = 0.007), retinal nerve fiber layer thickness (OR = 0.92/μm increase in thickness, P = 0.02), and peripapillary vessel density (OR = 0.80/unit increase in density, P = 0.01).
In a cross-sectional study, choroidal microvascular dropout (CMvD) in primary angle-closure glaucoma (PACG) eyes was associated only with visual field mean deviation (MD, OR = 0.90/dB higher MD, P = 0.05).
In a cross-sectional study of 64 glaucoma patients, choroidal microvascular dropout (CMvD) was significantly associated with primary open-angle glaucoma (POAG) (OR > 3.5, P < 0.05) after accounting for glaucoma severity.
In a cross-sectional study, choroidal microvascular dropout (CMvD) was seen in 6 of 7 eyes with initial parafoveal scotoma (IPFS) and 1 of 13 with initial nasal defect (IND) in the primary open-angle glaucoma (POAG) group (P < 0.05).
In a cross-sectional study, choroidal microvascular dropout (CMvD) was seen in 1 of 2 eyes with initial parafoveal scotoma (IPFS) and 0 of 10 with initial nasal defect (IND) in the primary angle-closure glaucoma (PACG) group (P < 0.05).
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