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Charles DeBoer, Hossein Ameri; Retinal Ischemia Location in New Onset Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3207.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the distribution of retinal capillary non-perfusion in neovascular glaucoma (NVG) using ultra-widefield fluorescein angiography.
This is a single-center retrospective cross-sectional study of patients seen at Los Angeles County + University of Southern California (LAC + USC) Medical center from January 2015 to October 2019. Patients were screened for a new diagnosis of neovascular glaucoma with ultra-widefield fluorescein angiography (UWFA) performed prior to panretinal photocoagulation (PRP). Images with poor quality due to media opacity or interference with eyelids were excluded. A total of 15 eyes from 13 patients met inclusion criteria. Three concentric perfusion zones were used based on prior literature: Zone 1, the posterior pole, consisting of an area under 10mm from the fovea, Zone 2, the mid periphery, 10-15 mm from the fovea, and Zone 3, the far periphery, >15mm from the fovea. The ischemic index was calculated using the proportion of non-perfusion divided by total area of perfusion captured in the image using ImageJ software (National Institutes of Health, Bethesda, MD). Portions of the image that were obscured were not included in analysis.
The etiology of NVG was from proliferative diabetic retinopathy (n=11) and retinal vein occlusion, (n=2). The time between diagnosis and imaging was between 0 and 83 days, with a mean of 15.8 days and a median time of 1 day. The age of patients was between 48 and 74 years with a mean of 56 years. 6 of the 13 patients were male. Capillary non-perfusion was found to be 74% overall with 37% in Zone 1, 77% in Zone 2, and 92% in Zone 3.
Capillary perfusion was significantly reduced for subjects with NVG, with an average of 74% non-perfusion overall. Non-perfusion was worse in the peripheral retina (Zone 3), followed by the mid-periphery (Zone 2) and then the posterior pole (Zone 1).
This is a 2020 ARVO Annual Meeting abstract.
Image of analysis with three Zones as well as demarcated areas of capillary perfusion.
Percentage of capillary non-perfusion versus Zone (error bars representing standard error of the mean). Illustration depicts three zones analyzed.
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