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Jens Ulrich Werner, Christian Enders, Gerhard K Lang, Gabriele Elisabeth Lang; Optical coherence tomography angiography in glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2961.
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© 2017 Association for Research in Vision and Ophthalmology.
Glaucoma is characterized by the loss of retinal ganglion cells (RGC). There is evidence that glaucoma is also associated with vascular dysfunction. We hypothesize that there is a correlation between retinal thickness and capillary network perfusion measured by the novel optical coherence tomography angiography (OCTA) technique in glaucoma patients.
We examined 10 eyes from male and female patients aged from 61 to 85 years with open angle glaucoma and ten matched normal eyes using the Carl Zeiss Meditec Inc. Cirrus 5000 with the AngioPlex module at present allowing qualitative analysis in a prospective study. Capillary network was analyzed in the retinal superficial (SCL) and deep capillary layer (DCL) as well as the retinal thickness (RT). All measurements were performed in a 6x6 mm quadrat around the optic disc and the macula. Images were composed to a panorama showing optic disc and macula. A qualitative analysis of the overlay of RT/SCL and RT/DCL was performed relating to RT and capillary network in the SCL and DCL.
A correlation was found between peripapillary and macular capillary network perfusion and RT. In areas with thinned RT compared to non-glaucomatous patients the density of capillary network was reduced. In 2 of 10 patients this is more evident in the SCL and in 3 of 10 patients the capillary perfusion disorder was more pronounced in the DCL.
Glaucoma seems to be associated with a thinning in the capillary network of the retina. It is unclear whether the capillary bed diminishes due to the loss of RGC or the impaired perfusion induces cell death of the RGC. This study encourages to further analyze the retinal capillary network in glaucoma patients. This novel OCTA technique allows 3-dimensional non-invasive microvascular visualization and enables new insights into the pathology of glaucoma. OCTA might be a novel tool for glaucoma diagnosis and progression analysis.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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