July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Systemic Determinants of Peripapillary Vessel Density in the African American Eye Disease Study
Author Affiliations & Notes
  • Ryuna Chang
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Andrew Nelson
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Vivan LeTran
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Brian Vu
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Bruce Burkemper
    Southern California Eyecare and Vision Research Institute, Los Angeles, California, United States
  • Zhongdi Chu
    Bioengineering, University of Washington, Seattle, Washington, United States
  • Ali Fard
    Carl Zeiss Meditec, Inc., California, United States
  • Amir H. Kashani
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Benjamin Xu
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Ruikang K Wang
    Bioengineering, University of Washington, Seattle, Washington, United States
  • Rohit Varma
    Southern California Eyecare and Vision Research Institute, Los Angeles, California, United States
  • Grace Marie Richter
    Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Ryuna Chang, None; Andrew Nelson, None; Vivan LeTran, None; Brian Vu, None; Bruce Burkemper, None; Zhongdi Chu, None; Ali Fard, Carl Zeiss Meditec, Inc. (E); Amir Kashani, Carl Zeiss Meditec, Inc. (C), Carl Zeiss Meditec, Inc. (F); Benjamin Xu, None; Ruikang Wang, Carl Zeiss Meditec, Inc. (P), Carl Zeiss Meditec, Inc. (C); Rohit Varma, None; Grace Richter, Carl Zeiss Meditec, Inc. (F)
  • Footnotes
    Support  NH Grants K23EY027855-01, U10EY023575; American Glaucoma Society Young Clinician Scientist Grant
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4272. doi:
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      Ryuna Chang, Andrew Nelson, Vivan LeTran, Brian Vu, Bruce Burkemper, Zhongdi Chu, Ali Fard, Amir H. Kashani, Benjamin Xu, Ruikang K Wang, Rohit Varma, Grace Marie Richter; Systemic Determinants of Peripapillary Vessel Density in the African American Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4272.

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

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Abstract

Purpose : Radial peripapillary capillary (RPC) vessel density (VD) is associated with glaucomatous nerve damage, but we do not know the temporal relationship between development of vascular changes and optic nerve damage. African Americans (AA) carry a greater burden of both glaucoma and systemic vascular disease compared to other populations. We hypothesize that presence of systemic vascular disease may contribute to reduced RPC VD and greater risk of glaucoma. This study sought to determine the relationship between systemic factors and RPC VD in AA.

Methods : 6x6mm optic nerve spectral-domain optical coherence tomography angiography (OCTA) scans were obtained using CIRRUS 5000 HD-OCT with AngioPlex (ZEISS, Dublin, CA) on participants of the population-based African American Eye Disease Study, ages 40 years and older in Inglewood, California. Participants with glaucoma, severe non-proliferative diabetic retinopathy (NPDR), and PDR were excluded to reduce RPC VD variation from ocular disease. Custom software was used to quantify RPC VD. Multivariable linear regression was used to identify systemic factors associated with RPC VD with a significance level set at 0.05. Candidate variables were: age, gender, presence and duration of diabetes mellitus, blood pressure, use of antihypertensive medication, smoking status, and signal strength.

Results : 3840 eyes from 2025 participants received OCTA imaging. Of these, 1473 eyes from 1042 participants had both signal strength ≥ 7 out of 10 and images free of motion artifact, media opacities, or decentration based on a standardized image quality grading algorithm. In total, 1042 eyes from 1042 participants were analyzed. Average RPC VD was 0.345 ± 0.048. Controlling for signal strength, the variables in the final multivariate model significantly associated with reduced RPC VD were: older age (β = -0.013 per 10 years; standardized regression coefficient [SRC] = -0.264; p = <0.001), male gender (β = -0.007; SRC = 0.071; p = 0.006), and longer diabetes duration (β = -0.003 per 5 years; SRC = -0.066; p = 0.011). The model R2 was 0.361.

Conclusions : Aging and systemic influences, such as diabetes duration, need to be considered when assessing reduction in RPC VD in glaucoma and other ocular diseases. Longitudinal studies are needed to investigate whether these factors affecting RPC VD are associated with an increased risk of developing glaucomatous nerve damage.

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

 

 

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