July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Longitudinal Changes in Optical Coherence Tomography Angiography (OCTA) Vessel Density and Thickness in Glaucoma Eyes with Focal Lamina Cribrosa Defects
Author Affiliations & Notes
  • James Alexander Proudfoot
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Min Hee Suh
    Ophthalmology, Inje University College of Medicine, Korea (the Republic of)
  • Robert N Weinreb
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Christopher Bowd
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Patricia Manalastas
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Elham Ghahari
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Sasan Moghimi
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Rafaella Penteado
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Huiyuan Hou
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Linda M Zangwill
    Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, California, United States
  • Footnotes
    Commercial Relationships   James Proudfoot, None; Min Hee Suh, None; Robert Weinreb, Aerie Phamaceuticals (C), Allergan (C), Carl Zeiss Meditec (F), Centervue (F), Genentech (F), Heidelberg Engineering (F), Konan Medical (F), National Eye Institute (F), Optos (F), Optovue (F), Research to Prevent Blindness (F); Christopher Bowd, None; Patricia Manalastas, None; Elham Ghahari, None; Sasan Moghimi, None; Rafaella Penteado, None; Huiyuan Hou, None; Linda Zangwill, Carl Zeiss Meditec (F), Heidelberg Engineering (F), National Eye Institute (F), Optovue (F), Topcon Medical System Inc. (F)
  • Footnotes
    Support  EY11008, EY19869, EY14267, EY027510, EY026574, P30EY022589, EY029058 and 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 and by the donors of the National Glaucoma Research Program, a program of the BrightFocus Foundation.
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5605. doi:https://doi.org/
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      James Alexander Proudfoot, Min Hee Suh, Robert N Weinreb, Christopher Bowd, Patricia Manalastas, Elham Ghahari, Sasan Moghimi, Rafaella Penteado, Huiyuan Hou, Linda M Zangwill; Longitudinal Changes in Optical Coherence Tomography Angiography (OCTA) Vessel Density and Thickness in Glaucoma Eyes with Focal Lamina Cribrosa Defects. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5605. doi: https://doi.org/.

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

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Abstract

Purpose : To determine if the rate of longitudinal changes in vessel density and thickness is faster in glaucoma eyes with focal lamina cribrosa defects (LCD).

Methods : OptoVue Avanti OCTA macula (3 x 3 mm2) and ONH (4.5 x 4.5 mm2) scans and Spectralis optic nerve head (ONH) circle scans were obtained from 74 eyes of 64 glaucoma patients with 3 visits and > 1 year of follow-up from the Diagnostic Innovations in Glaucoma Study (DIGS). LCD were detected using swept-source OCT. Multivariable (including image quality) and weighted multivariable linear mixed models were used to assess differences in rates of change between eyes with and without LCD, with weights derived from propensity scores calculated in a boosted logistic regression, balancing age, baseline MD, and gender between LCD groups.

Results : The median follow-up time (2.7 years, range: 1.0 to 3.5), median number of visits (4) and mean (95% CI) baseline MD (-5.0 (-6.0, -4.0) dB) in the eyes with LCD (n=36) and without LCD (n=38) were similar. In eyes with and without LCD, the rates of change in ONH and macular superficial vessel density were significantly different from zero. A faster decrease in deep layer macula whole image vessel density (wiVD) and parafoveal vessel density (pfVD) was observed in the LCD positive group in the superior hemisphere (wiVD: (LCD rate (95% CI) -0.41%/yr (-0.94%, 0.12%), no LCD rate 0.38%/yr (-0.16%, 0.92%) p = 0.042), pvVD: LCD rate (95% CI) -0.40%/yr (-1.02%, 0.21%), no LCD rate 0.49%/yr (-0.12%, 1.11%) p = 0.044). The circumpapillary retinal nerve fiber layer (RNFL) decreased faster in the LCD positive group (LCD rate (95% CI) -0.69 (-1.17, -0.21) mm/yr, no LCD rate 0.17 (-0.31, 0.66) mm/yr, p=0.017), as did RNFL thickness in the inferior-temporal (LCD rate (95% CI) -1.91 (-3.04, -0.77) mm/yr, no LCD rate 0.01 (-1.16, 1.18) mm/yr, p=0.029). There were no differences found in the rate of ONH vessel density dropout between eyes with and without LCD.

Conclusions : With a relatively short follow-up of 2.7 years, this study suggests that ONH and microvascular dropout is detectable, and that the rate of RNFL thinning and deep layer vessel density loss is faster in eyes with LCD. Longer follow-up is needed to determine the relationship between microvascular dropout and lamina changes.

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

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