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Microvascular and structural alterations in the optic nerve head of advanced primary open-angle glaucoma compared with atrophic non-arteritic anterior ischemic optic neuropathy

  • Glaucoma
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Abstract

Purpose

This cross-sectional study compared the peripapillary vessel density (VD), peripapillary retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters between eyes with atrophic non-arteritic anterior ischemic optic neuropathy (NAION) and eyes with advanced primary open-angle glaucoma (POAG) matched for visual field mean deviation.

Methods

Peripapillary VDs and RNFL thicknesses in the peripapillary region, and 4 sectors (superior, inferior, nasal, and temporal), and scanning laser ophthalmoscopy parameters of the ONH were evaluated with optical coherence tomography angiography (OCTA) among 21 atrophic NAION cases, 26 advanced POAG cases, and 30 age- and sex-matched healthy controls.

Results

The POAG eyes had lower peripapillary VDs in all areas compared with the NAION eyes, which was most marked in the inferior and nasal sectors (p=0.005 for both). RNFL loss was similar between the 2 groups in all areas, except for a preserved thickness in the inferior sector in NAION eyes (p=0.01). Peripapillary VD demonstrated stronger correlations with global RNFL thickness in the peripapillary region in the NAION eyes compared with that of the POAG eyes (r=0.91 p<0.00001, r=0.42 p=0.03 respectively). In multivariate analysis, the peripapillary VD correlated with age and RNFL thickness in the POAG eyes while it correlated with SSI and RNFL thickness in the NAION eyes.

Conclusions

A tendency for a lower peripapillary VD despite similar visual field mean deviation values may infer a more prominent role of the vascular regression in POAG compared with NAION.

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Authors and Affiliations

  1. Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ankara, Turkey

    Gozde Hondur & Emine Sen

  2. Department of Ophthalmology, Erzincan Binali Yildirim University School of Medicine, Erzincan, Turkey

    Ozlem Budakoglu

Authors
  1. Gozde Hondur
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  2. Emine Sen
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  3. Ozlem Budakoglu
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Corresponding author

Correspondence to Gozde Hondur.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ankara Education and Research Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the individual participants included in the study.

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The authors declare no competing interests.

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Hondur, G., Sen, E. & Budakoglu, O. Microvascular and structural alterations in the optic nerve head of advanced primary open-angle glaucoma compared with atrophic non-arteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 259, 1945–1953 (2021). https://doi.org/10.1007/s00417-021-05122-2

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  • DOI: https://doi.org/10.1007/s00417-021-05122-2

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