July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Peripapillary Vessel Density as a Glaucoma Biomarker throughout the Glaucoma Severity Spectrum
Author Affiliations & Notes
  • Ravneet Singh Rai
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Katie Lucy
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Nathaniel Tracer
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Mengfei Wu
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Mengling Liu
    Departments of Population Health and Environmental Medicine, NYU Langone Health, New York, New York, United States
  • Maria de los Angeles Ramos Cadena
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Siddarth Rathi
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Assumpta Madu
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Hiroshi Ishikawa
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Joel Schuman
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Gadi Wollstein
    NYU Eye Center, NYU Langone Health, New York, New York, United States
  • Footnotes
    Commercial Relationships   Ravneet Rai, None; Katie Lucy, None; Nathaniel Tracer, None; Mengfei Wu, None; Mengling Liu, None; Maria de los Angeles Ramos Cadena, None; Siddarth Rathi, None; Assumpta Madu, None; Hiroshi Ishikawa, None; Joel Schuman, Zeiss (P); Gadi Wollstein, None
  • Footnotes
    Support  NIH: R01-EY013178
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3042. doi:https://doi.org/
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      Ravneet Singh Rai, Katie Lucy, Nathaniel Tracer, Mengfei Wu, Mengling Liu, Maria de los Angeles Ramos Cadena, Siddarth Rathi, Assumpta Madu, Hiroshi Ishikawa, Joel Schuman, Gadi Wollstein; Peripapillary Vessel Density as a Glaucoma Biomarker throughout the Glaucoma Severity Spectrum. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3042. doi: https://doi.org/.

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

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Abstract

Purpose : Structural parameters are commonly used to track the progression of glaucoma. In this study, we investigated if peripapillary vessel density (VD), measured by optical coherence tomography angiography (OCTA), is associated with glaucoma severity and thus may be used to track glaucoma progression.

Methods : 82 eyes of 50 subjects ranging from glaucoma suspect to severe glaucoma were included in the study. Subjects with diabetes, vascular disease, or using medications known to affect visual field were excluded. 3x3 mm optic nerve head (ONH) OCTA images were obtained on all subjects using a Cirrus HD-OCT Angioplex (Zeiss, Dublin, CA) device. VD was calculated using the native software on the device. Best-fit models (linear regression or piecewise regression with Davies test to detect tipping points) were used to describe the associations between VD and RNFL and GCIPL thicknesses, rim area, cup-to-disc (C/D) ratio, and visual field mean deviation (MD).

Results : The median age was 61 years (range 20 to 86) with a median MD of -1.4dB (range 2.3 to -33.5dB) and a mean RNFL thickness of 78.4μm (SD=14.2, range 43 to 118μm). Statistically significant linear associations were found between peripapillary VD and RNFL thickness, GCIPL thickness, and rim area (all p<0.001; Figure 1). Association between VD and C/D ratio and MD showed a tipping point at 0.73 (p=0.005) and -3.3dB (p<0.001), respectively (Figure 1). In advanced glaucoma, the rate of change in C/D ratio slowed, while the VD measurements varied over a wide range. In early glaucoma, there was limited change in MD values, again with a wide range in VD measurements. Coefficients of determination (R2) were statistically significant between peripapillary vessel density, structural parameters, and MD (all p≤0.001; Table 1).

Conclusions : Peripapillary VD is significantly associated with conventional glaucoma severity biomarkers. The wide dynamic range of VD in early and advanced disease indicates that VD may be a useful biomarker at stages where diagnosis and progression detection is particularly difficult. Further longitudinal analysis is warranted.

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

 

Figure 1: Peripapillary VD against RNFL thickness, GCIPL thickness, rim area, average C/D ratio, and MD.

Figure 1: Peripapillary VD against RNFL thickness, GCIPL thickness, rim area, average C/D ratio, and MD.

 

Table 1: Coefficients of determination between peripapillary vessel density, structural biomarkers, and MD.

Table 1: Coefficients of determination between peripapillary vessel density, structural biomarkers, and MD.

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