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Min Hee Suh, Linda M Zangwill, Akram Belghith, Adeleh Yarmohammadi, Patricia Isabel C Manalastas, Alberto Diniz-Filho, Naeem Fatehee, Siamak Yousefi, Robert N Weinreb; Diagnostic Innovations in Glaucoma Study (DIGS): OCT Angiography Vessel Density in Glaucomatous Eyes with Focal Lamina Cribrosa Defects. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Influence of anatomical differences of the lamina cribrosa (LC) on the vascular hemodynamics of the optic nerve head remains unknown. Optical coherence tomography angiography (OCTA) provides in vivo images of the vessel density located within the peripapillary retinal nerve fiber layer (RNFL). The present study investigated whether peripapillary RNFL vessel density assessed by OCTA is reduced in glaucomatous eyes with a focal LC defect by swept-source OCT (SS-OCT).
Among 130 eyes with open angle glaucoma, 58 (44.6 %) eyes had focal LC defects and 72 (55.4 %) did not have a defect based on the serial horizontal B-scan images of the SS-OCT. For the measurement of the circumpapillary vessel density and RNFL thickness, the optic disc region was imaged with spectral-domain OCT. Only good quality OCTA images identified according to the Shiley Eye Institute Imaging Data Evaluation and Analysis (IDEA) Reading Center protocol were included. Circumpapillary vessel density was calculated as the percentage area occupied by actively flowing vessels in the measured region by the OCTA. Circumpapillary vessel densities and RNFL thicknesses were compared in global area and in 8 45○-sized sectors between eyes with and without LC defects.
Mean circumpapillary vessel densities of eyes with LC defects were significantly lower than those without defects in global area, and in superotemporal (ST), superonasal (SN), inferotemporal (IT), and inferonasal (IN) sectors (P < 0.05). Sector differences were highest in the IT (54.2 ± 1.5 vs. 59.3 ± 1.4 %, respectively) followed by ST (56.9 ± 1.1 vs. 60.8 ± 1.0 %, respectively), IN (54.9 ± 1.1 vs. 57.9 ± 1.0 %, respectively), and SN (54.3 ± 1.0 vs. 56.8 ± 0.8 %, respectively) sectors. Age, circumpapillary RNFL thicknesses in all areas, visual field MD and pattern standard deviation, presence of the optic disc hemorrhage, mean ocular perfusion pressure and intraocular pressure were not different between the two groups (P > 0.05).
Circumpapillary vessel density was significantly lower in glaucomatous eyes with focal LC defects than those without defects, while glaucoma severity did not differ between the two groups. These differences were highest in superotemporal and inferotemporal sectors.
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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