June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Peripapillary Perfused Capillary Density in Exfoliation Syndrome and Exfoliation Glaucoma versus Primary Open-Angle Glaucoma and Healthy Controls: an Optical Coherence Tomography Angiography Study
Author Affiliations & Notes
  • Yanin Suwan
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, New York, New York, United States
    Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Lawrence Geyman
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Masoud A Fard
    Farabi Eye Hospital, Tehran, Iran (the Islamic Republic of)
  • Apichat Tantraworasin
    Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Toco Yuen Ping Chui
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, New York, New York, United States
  • Richard B Rosen
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, New York, New York, United States
  • Robert Ritch
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, New York, New York, United States
  • Footnotes
    Commercial Relationships   Yanin Suwan, None; Lawrence Geyman, None; Masoud Fard, None; Apichat Tantraworasin, None; Toco Chui, None; Richard Rosen, Carl Zeiss Meditech (C), Optovue (C); Robert Ritch, The Ablon Family Research Fund of the New York Glaucoma Research Institute (F)
  • Footnotes
    Support  The Ablon Family Research Fund of the New York Glaucoma Research Institute
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 718. doi:
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      Yanin Suwan, Lawrence Geyman, Masoud A Fard, Apichat Tantraworasin, Toco Yuen Ping Chui, Richard B Rosen, Robert Ritch; Peripapillary Perfused Capillary Density in Exfoliation Syndrome and Exfoliation Glaucoma versus Primary Open-Angle Glaucoma and Healthy Controls: an Optical Coherence Tomography Angiography Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):718.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the peripapillary perfused capillary density (PCD) among eyes with exfoliation syndrome (XFS), exfoliation glaucoma (XFG), primary open-angle glaucoma (POAG), and controls.

Methods : 4.5x4.5 mm optical coherence tomography angiography (OCTA) images of the optic nerve head were obtained using a commercial spectral domain OCTA system (AngioVue Avanti RTVue-XR, OptoVue, Fremont, CA). Two concentric circles with 1.95-mm (inner) and 3.45-mm (outer) diameters were placed manually, producing an annulus of width 0.75 mm centered at the optic disc. After the removal of large blood vessels, capillary network located between the inner limiting membrane and the posterior boundary of the RNFL was included for perfused capillary density (Scripsema et al. IOVS 2016). Perfused capillary density was calculated as the ratio of pixels associated with capillaries to the number of pixels in the annulus after large blood vessel removal. Continuous variables were assessed by analysis of variance and Tukey’s test. Multiple linear regression analysis was performed to adjust for confounding factors.

Results : 33 XFS eyes, 39 XFG eyes (visual field mean deviation (VF MD), -7.8±6.8 dB), 32 POAG eyes (VF MD, -9.3±9.4 dB), and 46 control eyes were included for analysis. Mean ages and axial lengths are shown in Table 1. PCD demonstrated a progressive stepwise decrease from control, XFS, POAG, to XFG (Fig 1). Pairwise comparisons revealed significant differences in PCD between each group (all p<0.05) except for XFS vs POAG (p=0.112). A multivariable model adjusting for age and stage showed a more significant decrease in PCD in XFG compared to POAG (p<0.001).

Conclusions : PCD was significantly decreased in XFG compared to POAG eyes and in XFS compared to control eyes. Decreased PCD precedes detectable VF defects in XFS. OCTA provides the first quantitative evidence of the microvascular disturbance which accompanies XFS and ultimately contributes to XFG.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Table 1. Clinical and Demographic Characteristics of XFS, XFG, POAG, and Control Groups

Table 1. Clinical and Demographic Characteristics of XFS, XFG, POAG, and Control Groups

 

Figure 1. OCTA Images Gray Scale (A) and Color Coded Perfused Capillary Density Map (B)
1A-B: Control, 2A-B: Exfoliation Syndrome, 3A-B: Exfoliation Glaucoma, 4A-B: Primary Open-Angle Glaucoma

Figure 1. OCTA Images Gray Scale (A) and Color Coded Perfused Capillary Density Map (B)
1A-B: Control, 2A-B: Exfoliation Syndrome, 3A-B: Exfoliation Glaucoma, 4A-B: Primary Open-Angle Glaucoma

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