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