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Evaluation of peripapillary atrophy in early open-angle glaucoma using autofluorescence combined with optical coherence tomography

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Abstract

Purpose

To quantitatively analyze α-zone and β-zone peripapillary atrophy (PPA) in patients having early primary open-angle glaucoma (POAG) using fundus autofluorescence (FAF) in conjunction with spectral domain optical coherence tomography, colored photography and perimetry.

Design

This is an observational cross-sectional case–control study.

Methods

This study included 100 eyes (54 patients) of early to moderate POAG and 100 normal eyes (50 subjects). Ophthalmological examination, OCT for the optic nerve and FAF were performed. The extent of α-PPA and β-PPA was measured.

Results

The extent of α-PPA and β-PPA as measured by FAF had higher values in POAG group as compared to control group (p values 0.003 and ≤ 0.001 for the total nasal and temporal extents, respectively). However, the nasal alpha and temporal beta zones showed more values in POAG patients as compared to normal controls (p values 0.002 and 0.024). The difference between the total extents of either zones alone was not significant. B-scan OCT was able to positively detect both zones. Detecting the alpha zone was significantly higher in the control group, while beta zone detection was significantly higher in the POAG group (p values ≤ 0.001).

Conclusion

The sensitivity of alpha zone detection was equal using colored photographs, FAF and B-scan OCT. FAF showed superior results in estimating the beta zone extent although OCT was more accurate in the anatomical delineation of Bruch’s membrane and RPE termination. The nasal alpha and temporal beta zone extents could be taken as early indices for evaluating early glaucomatous optic neuropathy.

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Data availability

All data are available from the authors and can be shared only if a request conforming to the ethics statement is provided.

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Authors and Affiliations

  1. Department of Ophthalmology, National Institute of Diabetes and Endocrinology, National Organization for Teaching Hospitals and Institutes, Cairo, Egypt

    Sally Yousif Sayed

  2. Department of Ophthalmology, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt

    Karim Adly Raafat, Rania A. Ahmed & Riham S. H. M. Allam

Authors
  1. Sally Yousif Sayed
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  2. Karim Adly Raafat
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  3. Rania A. Ahmed
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  4. Riham S. H. M. Allam
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Contributions

SY was involved in examination, performing investigations and data collection (investigation, resources and data curation). KA helped in conceptualization, review editing and supervision. RAA contributed to conceptualization, participation in revising patients’ selection criteria and manuscript revision. RSHMA was involved in conceptualization, writing original draft, review editing, supervision and corresponding author. All authors have seen and approved the final version of the manuscript being submitted.

Corresponding author

Correspondence to Riham S. H. M. Allam.

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Conflict of interest

The authors have no conflicts of interest to declare.

Consent for publication

Written informed consent was obtained from all participants, provided that no data are published that could lead to personal identification.

Consent for participate

Written informed consent was obtained from all participants.

Ethical approval

Data collection conformed to all local laws and complied with the tenets of the Declaration of Helsinki. Written informed consent was obtained from all participants. The protocol was revised and approved by the review board of the Ophthalmology Department, Cairo University.

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Appendix

Appendix

See Supplemental Fig. 1 and Tables 5, 6.

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Sayed, S.Y., Raafat, K.A., Ahmed, R.A. et al. Evaluation of peripapillary atrophy in early open-angle glaucoma using autofluorescence combined with optical coherence tomography. Int Ophthalmol 41, 2405–2415 (2021). https://doi.org/10.1007/s10792-021-01795-0

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  • DOI: https://doi.org/10.1007/s10792-021-01795-0

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