July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Optical Coherence Tomography Angiography (OCTA) Measure of Macular Vessel Density in Exfoliation Glaucoma and Exfoliation Syndrome Compared to Primary Open Angle Glaucoma and Healthy Controls
Author Affiliations & Notes
  • Shawn Philip
    Einhorn Clinical Research Center , New York Eye and Ear Infirmary of Mount Sinai, New York , New York, United States
    Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, United States
  • Ahmad Najafi
    Einhorn Clinical Research Center , New York Eye and Ear Infirmary of Mount Sinai, New York , New York, United States
  • Luis Silva
    Einhorn Clinical Research Center , New York Eye and Ear Infirmary of Mount Sinai, New York , New York, United States
  • Apichat Tantraworasin
    Department of Surgery, Chiang Mai University, Chiang Mai, Thailand
  • Robert Ritch
    Einhorn Clinical Research Center , New York Eye and Ear Infirmary of Mount Sinai, New York , New York, United States
  • Footnotes
    Commercial Relationships   Shawn Philip, None; Ahmad Najafi, None; Luis Silva, None; Apichat Tantraworasin, None; Robert Ritch, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5053. doi:https://doi.org/
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      Shawn Philip, Ahmad Najafi, Luis Silva, Apichat Tantraworasin, Robert Ritch; Optical Coherence Tomography Angiography (OCTA) Measure of Macular Vessel Density in Exfoliation Glaucoma and Exfoliation Syndrome Compared to Primary Open Angle Glaucoma and Healthy Controls. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5053. doi: https://doi.org/.

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

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Abstract

Purpose : Glaucomatous damage to the macula has been well documented in recent studies. Exfoliation syndrome (XFS) is an age-related systemic disorder associated with ischemic vasculopathy and can lead to exfoliation glaucoma (XFG). A retrospective-observational study was done to explore vascular differences between XFG, XFS, primary open angle glaucoma (POAG), and healthy controls by comparing macular vessel density (MVD) using OCTA.

Methods : Volume scans (3x3mm) centered on the fovea were taken using a spectral domain OCTA system (Optovue Angiovue RTvue, Fremont, CA) in 4 groups: 21 XFG, 22 POAG, 14 XFS, and 18 control eyes. Glaucomatous eyes had Humphrey 10-2 visual field defects (VFD, Table 1). The superficial retinal capillary plexus at the macula was analyzed in 6 sectors with OCTA AngioAnalytics software. OCTA images with signal strength index < 50 were excluded from analysis.

Results : Analysis of variance showed statistically significant differences in MVD at all 6 sectors (superior and inferior hemifield, superior, inferior, temporal,nasal quadrant) between all groups (Table 1, p<.001). Analysis showed a progressive decrease in MVD from controls to XFS to POAG to XFG. General estimating equations with marginal model analysis between XFS and controls showed significant difference in MVD within all sectors (p<.05) except inferior (p=.066) but after age adjustment these results were not significant (p>.05). XFG MVD was statistically significantly lower in superior (p=.031) and nasal quadrants (p=.036) compared to POAG, but this was not significant after adjusting for stage and age (p>.05). Intergroup analysis between XFG-XFS, XFG-controls, and POAG-controls, showed statistically significant differences in MVD at all sectors (p<.05).

Conclusions : MVD was significantly lower in nasal and superior quadrants when comparing XFG and POAG although significance declined after adjusting for disease stage and age. Although significance faded after age adjustment, XFS MVD was lower compared to controls despite no VFD. Further study with larger age-adjusted sample size is needed to fully investigate possible vascular change at the macula in XFS.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Figure 1.(a)OCTA Image Gray Scale (b)Color Coded Perfusion Capillary Density Map 1ab:XFG, 2ab:POAG, 3ab:XFS, 4ab:Control

Figure 1.(a)OCTA Image Gray Scale (b)Color Coded Perfusion Capillary Density Map 1ab:XFG, 2ab:POAG, 3ab:XFS, 4ab:Control

 

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