The aim of our study was to compare macular and peripapillary vessel density using optical coherence tomography angiography (OCTA) between eyes with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG).
Thirty-six POAG and 34 PXG eyes with similar visual field defect (no statistically significant difference between average mean deviation and pattern standard deviation scores) were included. Macular superficial vessel density (msVD) in the superficial macular layer and foveal avascular zone (FAZ) parameters were assessed with (6 × 6 mm) and peripapillary vessel density (ppVD) in the radial peripapillary capillary (RPC) with (4.5 × 4.5 mm) OCTA scans. Area under the receiver operating curve was used for assessing diagnostic capability.
In PXG group, all msVD parameters had lesser values, and especially in parafoveal region, statistically significant decrease was shown (p = 0.008) in all subdivisions except nasal (p = 0.053). FAZ area was more larger in PXG [0.32(0.25–0.36)] than POAG [0.28(0.22–0.39)],(p = 0.944). FAZ density − 300 μm had statistically significant decrease in PXG (47.22 ± 6.92) according to POAG groups (50.63 ± 7.25) (p = 0.048). Most of RPC VD parameters had decreasing values in PXG group (p > 0.05). VDs and corresponding thicknesses had significant remarkable positive correlation in both macular and peripapillary regions. Significant remarkable negative correlations were observed between fovea VD and FAZ area, FAZ perimeter and between fovea thickness and FAZ area, FAZ perimeter.
PXG eyes were found to have lesser values in terms of VD in the macular area, especially in the parafoveal and FD-300 regions, compared to POAG eyes which had similar functional and structural glaucomatous damage. Patients whose etiology was PXG and who seemed to have the same functional damage as those with POAG were actually found to have greater macular vascular damage. In addition, it was observed that macular vascular parameters correlated with peripapillary vascular parameters.
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Tobe LA, Harris A, Hussain RM et al (2015) The role of retrobulbar and retinal circulation on optic nerve head and retinal nerve fibre layer structure in patients with open-angle glaucoma over an 18-month period. Br J Ophthalmol 99:609–612
Ritch R, Schlötzer-Schrehardt U (2001) Exfoliation syndrome. Surv Ophthalmol 45:265–315
Ritch R (2016) Systemic associations of exfoliation syndrome. Asia Pac J Ophthalmol 5:45–50
HelbigSchlötzer-Schrehardt HU, Noske W et al (1994) Anteriorchamber hypoxia and iris vasculopathy in pseudoexfoliation syndrome. Ger J Ophthalmol 3:148–215
Yuksel N, Vl K, Demirci A et al (2001) Comparison of blood flow velocities of the extraocular vessels in patients with pseudoexfoliation or primary open-angle glaucoma. Ophthalmologica 215:424–442
Rechtman E, Harris A, Kumar R et al (2003) An update on retinal circulation assessment technologies. Curr Eye Res 27:329–343
Chansangpetch S, Lin SC (2018) Optical coherence tomography angiography in glaucoma care. Curr Eye Res 43:1067–1082
Takusagawa HL, Liu L, Ma KN et al (2017) Projection-resolved optical coherence tomography angiography of macular retinal circulation in glaucoma. Ophthalmology 124:1589–1599
Yarmohammadi A, Zangwill LM, Diniz-Filho A et al (2017) Peripapillary and macular vessel density in patients with glaucoma and single-hemifield visual field defect. Ophthalmology 124:709–719
Triolo G, Rabiolo A, Shemonski ND, Fard A, Di Matteo F, Sacconi R, Bettin P, Magazzeni S, Querques G, Vazquez LE et al (2017) Optical coherence tomography angiography macular and peripapillary vessel perfusion density in healthy subjects, glaucoma suspects, and glaucoma patients. Invest Ophthalmol Vis Sci 58:5713–5722
Geyman LS, Garg RA, Suwan Y et al (2017) Peripapillary perfused capillary density in primary open-angle glaucoma across disease stage: an optical coherence tomography angiography study. Br J Ophthalmol 101:1261–1268
Kwon J, Choi J, Shin JW et al (2017) Alterations of the foveal avascular zone measured by optical coherence tomography angiography in glaucoma patients with central visual field defects. Invest Opthalmol Vis Sci 58:1637–1645
Suwan Y, Geyman LS, Fard MA et al (2018) Peripapillary perfused capillary density in exfoliation syndrome and exfoliation glaucoma vs POAG and healthy controls: an optical coherence tomography angiography study. Asia Pac J Ophthalmol 7:84–89
Rebolleda G, Pérez-Sarriegui A, De Juan V, Ortiz-Toquero S, Muñoz-Negrete FJ (2019) A comparison of two optical coherence tomography–angiography devices in pseudoexfoliation glaucoma versus primary open-angle glaucoma and healthy subjects. Eur J Ophthalmol 29:636–644
Philip S, Najafi A, Tantraworasin A, Chui TYP, Rosen RB, Ritch R (2019) Macula vessel density and foveal avascular zone parameters in exfoliation glaucoma compared to primary open-angle glaucoma. Invest Ophthalmol Vis Sci 60:1244–1253
Lommatzsch C, Rothaus K, Koch JM, Heinz C, Grisanti S (2019) Vessel density in glaucoma of different entities as measured with optical coherence tomography angiography. Clin Ophthalmol 13:2527–2534
Sample PA, Girkin CA, Zangwill LM et al (2009) The African descent and glaucoma evaluation study (adages): design and baseline data. Arch Ophthalmol 127(9):1136–1145
Gillespie BW, Musch DC, Guire KE, Mills RP, Lichter PR, Janz NK, Wren PA (2003) On behalf of the CIGTS (Collaborative Initial Glaucoma Treatment Study) Study Group. The collaborative initial glaucoma treatment study: baseline visual field and test-retest variability. Invest Ophthalmol Vis Sci 44:2613–2620
Wang W, He M, Zhou M et al (2014) Ocular pseudoexfoliation syndrome and vascular disease: a systematic review and meta-analysis. PLoS ONE 9:e92767
Meyer E, Haim T, Zonis S et al (1984) Pseudoexfoliation: epidemiology, clinical and scanning electron microscopic study. Ophthalmologica 188:141–147
Hammer T, Schlötzer-Schrehardt U, Naumann GO (2001) Unilateral or asymmetric pseudoexfoliation syndrome? An ultrastructual study. Arch Ophthalmol 119:1023–1031
Lu P, Xiao H, Liang C, Xu Y, Ye D, Huang J (2019) Quantitative analysis of microvasculature in macular and peripapillary regions in early primary open-angle glaucoma. Curr Eye Res 14:1–7
Park JH, Yoo C, Girard MJA, Mari JM, Kim YY (2018) Peripapillary vessel density in glaucomatous eyes: comparison between pseudoexfoliation glaucoma and primary open-angle glaucoma. J Glaucoma 27(11):1009–1016
Mase T, Ishibazawa A, Nagaoka T et al (2016) Radial peripapillary capillary network visualized using wide-field montage optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:504–510
Mansoori T, Sivaswamy J, Gamalapati JS et al (2017) Measurement of radial peripapillary capillary density in the normal human retina using optical coherence tomography angiography. J Glaucoma 26:241–246
Campbell JP, Zhang M, Hwang TS et al (2017) Detailed vascular anatomy of the human retina by projection-resolved optical coherence tomography angiography. Sci Rep 7:42201
Shoji T, Zangwill LM, Akagi T et al (2017) Progressive macula vessel density loss in primary open-angle glaucoma: a longitudinal study. Am J Ophthalmol 182:107–117
Hou H, Moghimi S, Proudfoot JA, Ghahari E, Penteado RC, Bowd C, Yang D, Weinreb RN (2020) Ganglion cell complex thickness and macular vessel density loss in primary open-angle glaucoma. Ophthalmology S0161–6420(20):30014–30022
Penteado RC, Bowd C, Proudfoot J, Moghimi S, Manalastas PIC, Ghahari E, Hou H, Shoji T, Zangwill LM, Weinreb RN (2020) Diagnostic ability of optical coherence tomography angiography macula vessel density for the diagnosis of glaucoma using difference scan sizes. J Glaucoma. https://doi.org/10.1097/IJG.0000000000001447
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Subasi, S., Yuksel, N., Basaran, E. et al. Comparison of vessel density in macular and peripapillary regions between primary open-angle glaucoma and pseudoexfoliation glaucoma using OCTA. Int Ophthalmol 41, 173–184 (2021). https://doi.org/10.1007/s10792-020-01564-5
- Optical coherence tomography angiography
- Primary open-angle glaucoma
- Pseudoexfoliation glaucoma
- Visual field defect