Original articleMacular and Optic Nerve Head Vessel Density and Progressive Retinal Nerve Fiber Layer Loss in Glaucoma
Section snippets
Methods
This was a longitudinal, observational cohort study including 132 eyes from 83 patients with POAG enrolled in the Diagnostic Innovations in Glaucoma Study who underwent OCTA (AngioVue; Optovue, Inc., Fremont, CA) and spectral-domain (SD) OCT ONH imaging (Heidelberg Engineering, Inc., Heidelberg, Germany). All the methods adhered to the tenets of the Declaration of Helsinki and to the Health Insurance Portability and Accountability Act. The institutional review boards at the University of
Results
After excluding poor-quality OCTA images (27 eyes) and poor-quality SD OCT images (10 eyes), 132 eyes of 83 patients (mean age, 68.7±10.4 years; mean SAP MD, –2.44±2.85 dB) were included in the analysis. Table 1 summarizes the baseline characteristics of the study participants. Average baseline m-wiVD and onh-wiVD were 50.0±3.7% and 52.4±3.7%, respectively. Average baseline RNFL thickness was 79.5±14.7 μm, which declined with a mean slope of –1.07 μm/year (95% confidence interval [CI], –1.28 to
Discussion
In this study, OCTA parameters were associated significantly with the rate of RNFL decline in patients with mild to moderate POAG followed up over time. Eyes with lower baseline m-wiVD and onh-wiVD tended to progress significantly faster than those with higher values. Such an association was present even in a multivariate model adjusting for structural parameters and factors known potentially to affect rates of glaucoma progression. These data demonstrate that vascular density parameters
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2023, American Journal of OphthalmologyCitation Excerpt :Findings from our longitudinal study provide novel and additional evidence to the elucidation of the vascular theory6-8 in glaucoma development by demonstrating that degeneration in retinal vasculature heralds the advent of glaucoma progression in NTG. Our current findings also corroborate with the longitudinal results from OCTA reported in a recent study by Moghimi and associates,48 which revealed that reduced optic nerve head and macular vessel density at baseline were associated with progressive RNFL thinning, both supporting a clinically significant role of vascular insufficiency in glaucoma development and progression. In this study, we also evaluated the application of DL-based retinal-vessel analysis in the clinical risk assessment of NTG.
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Supplemental material available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have made the following disclosure(s): L.M.Z.: Financial support - Carl Zeiss Meditec, Heidelberg Engineering, Topcon, Optovue.
T.S.: Financial support - Alcon.
R.N.W.: Financial support - Carl Zeiss Meditec, Genentech, Heidelberg Engineering, Konan, Optos, Optovue, Tomey, Topcon; Consultant - Aerie Pharmaceuticals, Alcon, Allergan, Bausch & Lomb, Eyenovia, Novartis, Unity.
Supported in part by the National Eye Institute, National Institutes of Health, Bethesda, Maryland (grant nos.: EY029058 [R.N.W.], EY011008 [L.M.Z.], EY14267 [L.M.Z.], and EY019869 [L.M.Z.]); the National Institutes of Health (core grant no.: P30EY022589); the Japan Society for the Promotion of Science (KAKENHI grant nos.: 15K21335 and 16KK0208 [T.S.]); an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York; by Alcon, Allergan, Pfizer, Merck, and Santen (grants for participants’ glaucoma medications); and by the donors of the National Glaucoma Research Program (a program of the BrightFocus Foundation).
HUMAN SUBJECTS: This study included human subjects or tissues. Study protocol was approved by the institutional review board of the University of California, San Diego. Informed consent was obtained from all human subjects. This research complied with the Health Insurance Portability and Accountability (HIPAA) Act of 1996 and adhered to the tenets of the Declaration of Helsinki.
No animals were used in this study.
Author Contributions:
Conception and design: Moghimi, Zangwill, Weinreb
Analysis and interpretation: Moghimi, Zangwill, Penteado, Hasenstab, Ghahari, Hou, Christopher, Yarmohammadi, Manalastas, Shoji, Bowd, Weinreb
Data collection: Moghimi, Zangwill, Penteado, Hasenstab, Ghahari, Hou, Christopher, Yarmohammadi, Manalastas, Shoji, Bowd, Weinreb
Obtained funding: None
Overall responsibility: Moghimi, Zangwill, Penteado, Hasenstab, Ghahari, Hou, Christopher, Yarmohammadi, Manalastas, Shoji, Bowd, Weinreb