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The role of optical coherence tomography angiography in moderate and advanced primary open-angle glaucoma

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Abstract

Purpose

To evaluate the relationship between structure and function in moderate and advanced primary open-angle glaucoma (POAG) and to determine the accuracy of structure and vasculature for discriminating moderate from advanced POAG.

Methods

In this cross-sectional study, 25 eyes with moderate and 40 eyes with advanced POAG were enrolled. All eyes underwent measurement of the thickness of circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell complex (GCC), and optical coherence tomography angiography (OCTA) of the optic nerve head (ONH) and macula. Visual field (VF) was evaluated by Swedish interactive threshold algorithm and 24–2 and 10–2 patterns. The correlation between structure and vasculature and the mean deviation (MD) of the VFs was evaluated by a partial correlation coefficient. The area under the receiver operating characteristic curve (AUC) was applied for assessing the power of variables for discrimination moderate from advanced POAG.

Results

Including all eyes, whole image vessel density (wiVD) of the ONH area, and vessel density (VD) in the inferior quadrant of perifovea were the parameters with significant correlation with the mean deviation (MD) of the VF 24–2 in OCTA of the ONH and macula (r = .649 and .397; p < .05). The greatest AUCs for discriminating moderate and advanced POAG belonged to VD of the inferior hemifield of ONH area (.886; 95% CI (.805, .967)), and VD in the inferior quadrant of perifovea (.833; 95% CI (.736, .930)) without statistically significant difference (.886 Versus .833; p = .601).

Conclusion

Among vascular parameters of the ONH area, wiVD had the strongest correlation with the MD of the VF 24–2 while VD of the inferior hemifield of the ONH area had the greatest AUC for discriminating moderate and advanced POAG. Vessel density in the inferior quadrant of perifovea had a significant correlation with the MD of VF 24–2 and also the greatest AUC for discriminating moderate and advanced POAG.

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Data availability

The data that support the findings of this study are available from the corresponding author, [SMT], upon reasonable request.

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The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran

    Yadollah Eslami, Sepideh Ghods, Massood Mohammadi, Mona Safizadeh, Ghasem Fakhraie, Reza Zarei, Zakieh Vahedian & Seyed Mehdi Tabatabaei

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  1. Yadollah Eslami
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Correspondence to Seyed Mehdi Tabatabaei.

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Conflict of interest

Yadollah Eslami declares that he has no conflict of interest. Sepideh Ghods declares that she has no conflict of interest. Massood Mohammadi declares that he has no conflict of interest. Mona Safizadeh declares that she has no conflict of interest. Ghasem Fakhraie declares that he has no conflict of interest. Reza Zarei declares that he has no conflict of interest. Zakieh Vahedian declares that she has no conflict of interest. Seyed Mehdi Tabatabaei declares that he has no conflict of interest.

Ethical approval

All procedures performed in this study which involve human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The IRB/ethical committee of Tehran University of the Medical Sciences approved the study (IR.TUMS.MEDICINE.REC.1397.724).

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Eslami, Y., Ghods, S., Mohammadi, M. et al. The role of optical coherence tomography angiography in moderate and advanced primary open-angle glaucoma. Int Ophthalmol 42, 3645–3659 (2022). https://doi.org/10.1007/s10792-022-02360-z

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