June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Peripapillary vessel area density changes among glaucoma and non-glaucoma patients
Author Affiliations & Notes
  • Joseph Juliano
    Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Andrew Nelson
    Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Bruce Burkemper
    Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Jae Chang Lee
    Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Brenda Ryuna Chang
    Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Zhongdi Chu
    Department of Bioengineering, University of Washington, Washington, United States
  • Ruikang K Wang
    Department of Bioengineering, University of Washington, Washington, United States
  • Rohit Varma
    Southern California Eyecare and Vision Research Institute, California, United States
  • Grace Marie Richter
    Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Joseph Juliano, None; Andrew Nelson, None; Bruce Burkemper, None; Jae Lee, None; Brenda Chang, None; Zhongdi Chu, None; Ruikang Wang, Carl Zeiss Meditec (F), Carl Zeiss Meditec (C), Carl Zeiss Meditec (P); Rohit Varma, None; Grace Richter, Carl Zeiss Meditec (F)
  • Footnotes
    Support  Research to Prevent Blindness 5K23EY027855-03, NIH Grant 5K23EY027855-03, NIH Grant U10EY023575
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 621. doi:
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      Joseph Juliano, Andrew Nelson, Bruce Burkemper, Jae Chang Lee, Brenda Ryuna Chang, Zhongdi Chu, Ruikang K Wang, Rohit Varma, Grace Marie Richter; Peripapillary vessel area density changes among glaucoma and non-glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2020;61(7):621.

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

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Abstract

Purpose : Previously systemic and ocular determinants of peripapillary vessel area density (pVAD) among healthy subjects in the African American Eye Disease Study (AFEDS); and intraocular pressure (IOP) was not an independent determinant of pVAD. The current study reports determinants of pVAD in glaucoma subjects and tests the hypothesis that axial length (AL) is an effect modifier of the IOP – pVAD relationship in glaucoma subjects, who, presumably, have disturbed retinal autoregulation.

Methods : 6x6-mm optic disc optical coherence tomography angiography (OCTA) scans (CIRRUS HD-OCT 5000) were performed on participants of AFEDS, a population-based study of African Americans aged 40 years and older residing in Inglewood, California. Subjects with poor quality images were excluded. A multivariable linear regression model using GEE methods to control for inter-eye correlation was used to examine whether pVAD was independently associated with the following variables: IOP, retinal nerve fiber layer (RNFL), and AL. Covariates in the model controlled for signal strength (SS) and age.

Results : Of 2127 subjects with OCTA imaging, 1028 healthy subjects (1539 eyes) and 65 glaucoma patients (86 eyes) met our inclusion criteria. Lower pVAD was significantly associated with glaucoma, with the following mean ± sd. estimates: 0.346 ± 0.04 in healthy subjects vs. 0.263 ± 0.066 in glaucoma subjects (p = <0.0001). Restricting to healthy subjects after controlling for age and SS, significant predictors of lower VAD were longer AL (p < 0.001) and thinner RNFL (p < 0.001), but not IOP (p = 0.277). Among glaucoma patients, higher IOP (p = 0.017) and thinner RNFL (p = <0.001) were the only significant predictors of lower pVAD, controlling for age and SS. After stratifying by AL, higher IOP was significantly associated with lower pVAD among glaucoma patients with longer AL (> 24.2 mm = upper 33rd percentile; p = 0.02), but not among those with shorter AL (≤ 23.22 mm; p = 0.454). IOP was not significantly associated with pVAD among healthy subjects in either AL stratum.

Conclusions : While IOP is not independently associated with pVAD among healthy subjects, higher IOP is associated with lower pVAD in glaucoma subjects. This relationship is stronger among glaucoma subjects with longer AL. These results support the hypothesis that disturbed retinal autoregulation is present in glaucoma subjects, and particularly among those with longer AL.

This is a 2020 ARVO Annual Meeting abstract.

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