scholarly journals Comparison of optical coherence tomography angiography metrics in primary angle-closure glaucoma and normal-tension glaucoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ruyue Shen ◽  
Yu Meng Wang ◽  
Carol Y. Cheung ◽  
Poemen P. Chan ◽  
Clement C. Tham

AbstractTo investigate the peripapillary vascular metrics in early normal tension glaucoma (NTG) and early primary angle closure glaucoma (PACG) eyes using optical coherence tomography angiography (OCT-A). One or both eyes of each subject were imaged for a 3 × 3 mm peripapillary region by swept-source OCT-A (DRI-OCT Triton, Topcon, Japan) and assessed by an automated MATLAB program. OCT-A metrics including circumpapillary vessel density (cpVD) and fractal dimension (cpFD) were compared. Their association with visual field (VF) parameters and retinal nerve fiber layer (RNFL) thickness were determined. Sixty-eight eyes of 51 PACG, 68 eyes of 48 NTG, and 68 eyes of 49 control subjects were cross-sectionally analyzed. NTG eyes had significantly lower global cpVD (52.369 ± 0.781%) compared with PACG eyes (55.389 ± 0.721%, P = 0.004) that had comparable disease severity and average RNFL thickness. Multivariable analysis revealed that, for PACG and NTG eyes, decreased cpVD ([PACG] β = −4.242; CI: −8.120, −0.363 vs [NTG] β = −5.531; CI: −9.472, −1.590) and cpFD ([PACG] β = −8.894;CI: −11.925, −5.864 vs [NTG] β = −12.064; CI: −17.095, −6.932) were associated with decreased RNFL thickness (all P ≤ 0.032); with a stronger association between decrease cpFD and decreased RNFL thickness in NTG eyes (P = 0.028). Decreased cpVD was associated with decrease mean deviation (MD) in NTG eyes (β = −0.707; CI: −1.090, −0.324; P ≤ 0.001) and not associated with the visual field parameters in PACG eyes. Early NTG had lower global cpVD compared with early PACG, despite similar disease severity and average RNFL thickness.

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Harsha L. Rao ◽  
Thanemozhi Srinivasan ◽  
Zia S. Pradhan ◽  
Shruthi Sreenivasaiah ◽  
Dhanaraj A.S. Rao ◽  
...  

2020 ◽  
Author(s):  
Ruyue Shen ◽  
Yu Wang ◽  
Carol Cheung ◽  
Clement Tham ◽  
Poemen Chan

Abstract Purpose: To investigate the peripapillary vascular metrics in early normal tension glaucoma (NTG) and early primary angle closure glaucoma (PACG) eyes using optical coherence tomography angiography (OCT-A).Methods: One or both eyes of each subjects were imaged for a 3x3mm peripapillary region by swept-source OCT-A (DRI-OCT Triton, Topcon, Japan) and assessed by an automated MATLAB program. OCT-A metrics including circumpapillary vessel density (cpVD) and fractal dimension (cpFD) were compared. Their association with visual field (VF) parameters and retinal nerve fiber layer (RNFL) thickness were determined.Results: Sixty-eight eyes of 51 PACG, 68 eyes of 48 NTG, and 68 eyes of 49 control subjects were cross-sectionally analyzed. NTG eyes had significantly lower global cpVD (52.369±0.781%) compared with PACG eyes (55.389±0.721%, P=0.004) that had comparable disease severity and average RNFL thickness. Multivariable analysis reviewed that, for PACG and NTG eyes, decreased cpVD ([PACG] β=-4.242; CI:-8.120, -0.363 vs [NTG] β=-5.531; CI:-9.472, -1.590) and cpFD ([PACG] β=-8.894;CI:-11.925, -5.864 vs [NTG] β=-12.064; CI:-17.095, -6.932) were associated with decreased RNFL thickness (all P≤0.032); with a stronger association between decrease cpFD and decreased RNFL thickness in NTG eyes (Fisher’s Z-test, P=0.045). Decreased cpVD was associated with decrease mean deviation (MD) in NTG eyes (β=-0.707; CI:-1.090, -0.324; P≤0.001) and not associated with the visual field parameters in PACG eyes. Conclusions: Early NTG had lower global cpVD compared with early PACG, despite similar disease severity and average RNFL thickness. Précis:Optical coherence tomography angiography observed a lower peripapillary microvascular perfusion in early NTG eyes compared with early PACG eyes, despite similar disease severity and retinal nerve fiber layer thickness.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junhong Jiang ◽  
Cong Ye ◽  
Cong Zhang ◽  
Wenqing Ye ◽  
Xiaoyan Wang ◽  
...  

AbstractDirect comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available. We aimed to compare the intraocular asymmetry of VF loss among patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF defects were categorized into 3 stages (early, moderate, and advanced), and each hemifield was divided into 5 regions according to the Glaucoma hemifield test (GHT). The mean total deviation (TD) of each GHT region was calculated. In the early stage, the paracentral, peripheral arcuate 1 and peripheral arcuate 2 regions in the superior hemifield in the NTG group had significantly worse mean TDs than their corresponding regions in the inferior hemifield. In the advanced stage, the central region in the superior hemifield in the PACG group had a significantly worse mean TD than that in the inferior hemifield. There was no significant difference in the mean TD for any of the five regions between hemifields across all severity levels in the in the HTG group. The superior hemifield was affected more severely than the inferior hemifield in all three subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG than in PACG and HTG.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongdong Lin ◽  
Shirong Chen ◽  
Mingzhi Zhang

Abstract Background The purpose of this study was to investigate diagnostic ability of peripapillary vessel density of primary angle closure glaucoma (PACG) eyes in quadrant and clock-hour sectors by optical coherence tomography angiography (OCTA). Methods This was a cross-sectional study on forty-one PACG patients (41eyes) and twenty-seven healthy subjects (27 eyes). All subjects underwent OCTA (DRI OCT Triton; Topcon Corporation, Tokyo, Japan) and peripapillary retinal nerve fiber layer (RNFL) thickness imaging with swept-source optical coherence tomography (OCT). The peripapillary vessel density of quadrant and clock-hour sectors was quantified by imageJ software. The diagnostic capability of OCTA and OCT parameters was evaluated by the areas under the receiver operating characteristics curves (AUCs). Pearson correlation analysis or Spearman correlation test was used to evaluate the correlation between vessel density parameters and related factors. Results Compared with the control group, the peripapillary vessel density of glaucomatous group was lower to different degrees in the four quadrants and each clock-hour sectors, and vessel density reduced most at 7 o’clock. The difference between the diagnostic ability of peripapillary vessel density and peripapillary RNFL thickness was not statistically significant, except 4 o’clock and inferior quadrant. The inferior quadrant peripapillary vessel density had the best diagnostic value (AUC0.969), followed by the 7 o’clock vessel density (AUC0.964), average vessel density (AUC0.939) and the 7 o’clock RNFL thickness (AUC0.919). The average peripapillary vessel density was correlated with average RNFL and visual field (VF) mean deviation (P < 0.001). Conclusions In PACG, the diagnostic ability of the peripapillary vessel density is equivalent to the peripapillary RNFL thickness. Understanding spatial characteristics of the peripapillary vessel density in PACG may be helpful for clinical diagnosis and monitoring the progress of diseases.


2022 ◽  
pp. bjophthalmol-2021-320541
Author(s):  
Shengjie Li ◽  
Yichao Qiu ◽  
Jian Yu ◽  
Mingxi Shao ◽  
Yingzhu Li ◽  
...  

AimTo evaluate the association between serum levels of complement component (C) 3, C4 and C1q and visual field (VF) loss in patients with primary angle closure glaucoma (PACG).MethodsIn this prospective cohort study, a total of 308 patients with PACG were included. The patients were followed up every 6 months (at least 2 years), with clinical examination and VF testing. Based on their sex and age, the subjects were stratified into male and female subgroups, and by age at <60 and ≥60 years per subgroup.ResultsOne hundred twenty-three (39.94%) patients showed glaucoma VF progression. The serum levels of C3, C4 and C1q were significantly lower (p<0.05) in the progression group compared with the non-progression group in the ≥60 years female subgroup. In female patients with age ≥60 years, (1) lower levels of baseline C3 (HR=0.98, p<0.001), C4 (HR=0.96, p=0.01) and C1q levels (HR=0.99, p=0.003) were associated with a greater risk of VF progression; (2) patients with lower C3 levels had significantly (p<0.05) higher rates of VF loss progression, similar to those with lower C4 and lower C1q levels; and (3) the generalised additive model revealed a negative correlation between baseline C3 (p<0.001), C4 (p<0.001) and C1q (p<0.001) levels with the risk of VF progression. No statistical significance was observed in the male (<60 and ≥60 years) and female (<60 years) subgroups.ConclusionDecreased C3, C4 and C1q levels at baseline were significantly associated with a greater risk of VF loss progression only in older women with PACG.


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