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The choroidal microvasculature of the parapapillary area as a biomarker of glaucoma development in the fellow eye of patients with unilateral glaucoma

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Abstract

Purpose

To investigate the factors associated with the development of glaucoma in the healthy eyes of unilateral glaucoma patients.

Materials and methods

This was a retrospective observational case series study. All participants had unilateral primary open-angle glaucoma at the initial visit and were divided into two groups: one in which the fellow eyes developed glaucoma during the follow-up period and one in which the fellow eyes remained healthy. A complete ophthalmic examination, including best-corrected visual acuity testing, slit-lamp examination, intraocular pressure measurement, retinal nerve fiber layer and optic disk photographs, a 30-2 visual field test, and optical coherence tomography with angiography, was performed over a follow-up period of at least 3 years.

Results

A total of fifty-six patients were enrolled, and over the course of the study period, 11 patients developed glaucoma in the fellow eyes, while the fellow eyes of 45 patients remained healthy. At the baseline, the glaucomatous eye had a larger area of beta parapapillary atrophy, lower parapapillary choroidal vascular density (pCVD) within the area, and a lower prevalence of microvascular dropout than normal fellow eyes (P < 0.001, 0.013, 0.001, respectively). In the multivariate analysis, a reduced pCVD in the gamma parapapillary atrophy (γPPA) region was significantly associated with the development of glaucoma in normal eyes (odds ratio, 0.566; 95% CI, 0.342, 0.935; P = 0.026).

Conclusions

The pCVD within the γPPA region at baseline is the risk factor for the development of glaucoma in the normal fellow eye of patients with unilateral glaucoma.

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Data availability

The datasets generated during the present study are available from the corresponding author on reasonable request.

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Acknowledgements

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Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea

    Sangyoon Kim & Jonghoon Shin

  2. Veterans Health Service Medical Center, Veterans Medical Research Institute, Seoul, Republic of Korea

    Je Hyun Seo

  3. Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea

    Keunheung Park

  4. Department of Ophthalmology, Pusan Medical Center, Busan, Korea

    Keunheung Park

  5. Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea

    Jonghoon Shin

Authors
  1. Sangyoon Kim
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  2. Je Hyun Seo
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  4. Jonghoon Shin
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Contributions

SK contributed to the design of the study, revising the article, and approving the version to be published. JHS contributed to the conception of the study, acquisition and interpretation of data and approving the version to be published. KP contributed to performing the statistical analysis and drafting the article. JS contributed to the design of the study, acquisition and interpretation of data, drafting the article, and approving the version to be published.

Corresponding author

Correspondence to Jonghoon Shin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by Institutional Review Board of Pusan National University Yangsan Hospital, South Korea.

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Kim, S., Seo, J.H., Park, K. et al. The choroidal microvasculature of the parapapillary area as a biomarker of glaucoma development in the fellow eye of patients with unilateral glaucoma. Int Ophthalmol 43, 313–324 (2023). https://doi.org/10.1007/s10792-022-02430-2

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  • DOI: https://doi.org/10.1007/s10792-022-02430-2

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