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Takuhei Shoji, Linda M Zangwill, Tadamichi Akagi, Luke J Saunders, Adeleh Yarmohammadi, Patricia Isabel C Manalastas, Rafaella Cleto Penteado, Felipe Medeiros, Robert N Weinreb; The Rate of Macular Microvascular Dropout is Faster in Glaucoma Eyes than Glaucoma Suspect and Healthy Eyes: A Longitudinal Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3396.
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© ARVO (1962-2015); The Authors (2016-present)
Decline in retinal microvasculature is suspected to be a key factor in the mechanisms underlying glaucomatous disease progression and can now be approximated non-invasively using optical coherence tomography angiography (OCT-A) measurements of vessel density. This study aimed to evaluate the association between glaucoma status and rate of change in macula vessel density measurements using OCT-A .
A total of 83 eyes from 22 healthy participants, 30 glaucoma suspects and 31 glaucoma patients enrolled in the Diagnostic Innovations in Glaucoma Study who had at least two visits and 12 months of follow up with OCT-A (Angiovue; Optovue, Fremont, CA) imaging were included. Vessel density was summarized as whole, superior and inferior en face image regions of the superficial macula. The rate of change in OCT-A vessel density was compared across diagnostic groups using generalized estimating equations (GEE) in this study.
All three diagnostic groups were followed for between 2.9-3.9 visits over 13 to 14 months on average. Baseline macular vessel density was higher in normal eyes followed by glaucoma suspects and glaucoma eyes for whole (52.3%, 48.9%, and 47.8%, respectively), superior (53.0%, 50.1%, and 48.5%, respectively) and inferior regions (52.6%, 49.7%, and 48.2%, respectively) (P < 0.001 for all). In univariate analysis, vessel density was significantly associated with age, diagnostic category, and SSI (all P < 0.05) for all regions. In multivariate analysis, the mean (95% CI) rate of macular whole enface vessel density change was faster in glaucoma eyes compared to glaucoma suspects (-2.44%/yr [-1.08% to -3.80%/yr]; p<0.001) and healthy eyes (-2.95%/yr [-0.93% to -4.97%/yr]); p=0.004). Glaucoma eyes also had a significantly faster rate of vessel density dropout than glaucoma suspect and healthy eyes in the inferior region (p=0.002 and p<0.001) and superior region (p=0.001 and p=0.083).
In this study with a short follow-up time, differences in significant macular vessel density change between groups were detected, with the rate of dropout faster in glaucoma patients compared to glaucoma suspect and healthy subjects.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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