July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Progressive Ganglion Cell Complex Thickness and Vessel Density Loss in Healthy, Pre-perimetric Glaucoma and Primary Open Angle Glaucoma Eyes
Author Affiliations & Notes
  • Huiyuan Hou
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Sasan Moghimi
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Linda M Zangwill
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • James Proudfoot
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Rafaella Penteado
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Elham Ghahari
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Haksu Kyung
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Christopher Bowd
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Andrew Li
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Jason Han Lee
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Diya Yang
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Robert N Weinreb
    Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UCSD, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Huiyuan Hou, None; Sasan Moghimi, None; Linda Zangwill, Carl Zeiss Meditec Inc. (F), Heidelberg (R), Heidelberg Engineering GmbH (F), National Eye Institute (F), Optovue Inc. (F), Topcon Medical Systems Inc. (F); James Proudfoot, None; Rafaella Penteado, None; Elham Ghahari, None; Haksu Kyung, None; Christopher Bowd, None; Andrew Li, None; Jason Lee, None; Diya Yang, None; Robert Weinreb, Aerie Pharmaceuticals (C), Allergan (C), Carl Zeiss Meditec (F), Centeruve (F), Eyenovia (C), Genentech (F), Heidelberg Engineering (F), Konan (F), Meditec-Zeiss (P), National Eye Institute (F), Optos (F), Optovue (F), Topcon and Bausch & Lomb (F), Toromedes (P), Unity (C)
  • Footnotes
    Support  EY029058, EY11008, EY027510, EY026574, P30EY022589, UCSD School of Medicine Summer Research Fellowship, participant retention incentive grants in the form of glaucoma medication at no cost from Novartis/Alcon Laboratories Inc, Allergan, Akorn, and Pfizer Inc. Unrestricted grant from Research to Prevent Blindness, New York, New York
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3281. doi:https://doi.org/
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      Huiyuan Hou, Sasan Moghimi, Linda M Zangwill, James Proudfoot, Rafaella Penteado, Elham Ghahari, Haksu Kyung, Christopher Bowd, Andrew Li, Jason Han Lee, Diya Yang, Robert N Weinreb; Progressive Ganglion Cell Complex Thickness and Vessel Density Loss in Healthy, Pre-perimetric Glaucoma and Primary Open Angle Glaucoma Eyes. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3281. doi: https://doi.org/.

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

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Abstract

Purpose : Glaucomatous damage involves the macula neural tissue and microvasculature. This study aimed to characterize the change over time of ganglion cell complex (GCC) thickness and vessel density in healthy, pre-perimetric glaucoma and primary open angle glaucoma (POAG) eyes.

Methods : A total of 144 eyes (22 healthy eyes, 33 pre-perimetric glaucoma eyes, and 89 POAG eyes) were included from the Diagnostic Innovations in Glaucoma Study observational cohort study. Optical coherence tomography angiography(OCT-A) based superficial macula vessel density and OCT based GCC thickness were evaluated simultaneously at each visit during follow-up. Only eyes with more than 3 visits were included.The mean follow-up time and number of visits were 2.10 years and 3.50 visits for healthy eyes, 2.71 years and 3.82 visits for pre-perimetric glaucoma eyes, and 2.60 years and 3.84 visits for POAG eyes.The dynamic range-based normalized rates of vessel density and thickness change of the same 3×3 mm macula scan region were calculated and compared using mixed effects models. The association between the rates of change and baseline mean deviation (MD) was evaluated.

Results : Significant rates of loss of both GCC thickness and vessel density were detectable in all diagnostic groups (all P<0.05 comparing with 0 slope). In healthy eyes and pre-perimetric glaucoma eyes, the normalized age-adjusted rates of GCC thinning and vessel density dropout were comparable (all P>0.05). In contrast, the normalized age-adjusted mean rate (95% CI) of macula vessel density dropout (-2.82 (-3.36, -2.27) %/year) in the glaucoma eyes was significantly faster than GCC thinning (-1.28 (-1.49, -1.06) %/year, P<0.001). Faster vessel density dropout rate was significantly associated with worse baseline MD in glaucoma eyes (P=0.007), but the association between GCC thinning rate and baseline MD was not significant (P=0.520).

Conclusions : In this cohort, both GCC thinning and vessel density dropout over time were detectable in all 3 diagnostic groups. In POAG eyes, macula vessel density dropout is faster than GCC thinning and associated with POAG severity. This suggests that macula vessel density is a good option for monitoring of eyes with existing POAG.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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