June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Hemiretinal vessel density asymmetry supplements diagnostic accuracy of retinal nerve fiber layer thickness for glaucoma
Author Affiliations & Notes
  • Kendra L Hong
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Bruce Burkemper
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Anna Urrea
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Ryuna Chang
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Jae Lee
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Vivian LeTran
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Zhongdi Chu
    Bioengineering, University of Washington, Seattle, Washington, United States
  • Xiao Zhou
    Bioengineering, University of Washington, Seattle, Washington, United States
  • Benjamin Xu
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Brandon Wong
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Brian J Song
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Xuejuan Jiang
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Ruikang K Wang
    Bioengineering, University of Washington, Seattle, Washington, United States
  • Rohit Varma
    Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, California, United States
  • Grace Richter
    Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Kendra Hong, None; Bruce Burkemper, None; Anna Urrea, None; Ryuna Chang, None; Jae Lee, None; Vivian LeTran, None; Zhongdi Chu, None; Xiao Zhou, None; Benjamin Xu, None; Brandon Wong, None; Brian Song, None; Xuejuan Jiang, 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  NIH K23EY027855-01, NIH U10EY023575, NIH R01EY028753, NIH K23EY029763, American Glaucoma Society Young Clinician Scientist grant, an unrestricted grant to the USC Department of Ophthalmology from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1863. doi:
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    • Get Citation

      Kendra L Hong, Bruce Burkemper, Anna Urrea, Ryuna Chang, Jae Lee, Vivian LeTran, Zhongdi Chu, Xiao Zhou, Benjamin Xu, Brandon Wong, Brian J Song, Xuejuan Jiang, Ruikang K Wang, Rohit Varma, Grace Richter; Hemiretinal vessel density asymmetry supplements diagnostic accuracy of retinal nerve fiber layer thickness for glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1863.

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

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Abstract

Purpose : This study investigates hemiretinal asymmetry in radial peripapillary capillary vessel area density (VAD) of healthy, glaucoma suspect, and primary open angle glaucoma (POAG) eyes of varying severity, and its diagnostic utility, alone and in combination with other ocular parameters, for POAG.

Methods : 6x6-mm optic disc scans were collected on optical coherence tomography angiography to obtain VAD and on OCT to measure circumpapillary retinal nerve fiber layer (RNFL) thickness. Hemiretinal difference in VAD (hdVAD) was defined as the absolute difference between superior and inferior hemiretinal VAD. Age-adjusted multivariable linear regression of hdVAD on POAG severity was performed. Area under curves (AUCs) were calculated from predicted probabilities generated by multiple logistic regression of POAG severity on age-adjusted values of either a single parameter or a combination of parameters. DeLong’s test was used to determine the statistical significance of differences in AUCs from various models, thus identifying parameters with the greatest diagnostic accuracy.

Results : 1069 eyes of 1069 participants (602 healthy, 275 glaucoma suspect, and 192 POAG classified into 70 mild, 56 moderate, and 66 severe POAG) were included. After adjusting for age, mean hdVAD was similar between healthy and suspect (β = 0.002, P = 0.253), higher in mild versus suspect (β = 0.013, P < 0.001), higher in moderate versus mild (β = 0.010, P = 0.009), but lower in severe versus moderate (β = -0.012, P = 0.001). AUCs of hdVAD were qualitatively highest for mild (0.674) and moderate (0.685) POAG (versus 0.515 for suspect, 0.602 for severe POAG, 0.655 for any POAG). A combination of hdVAD and global RNFL (gRNFL) had the highest AUC of all parameters for mild (0.809) and any POAG (0.851), which were greater than AUCs of either hdVAD (P < 0.001 for both comparisons) or gRNFL (P = 0.041 for mild, P = 0.048 for any POAG) alone.

Conclusions : hdVAD is higher in early POAG and may help with early detection when damage is focal, but its diagnostic ability appears to be less robust in advanced POAG when damage is diffuse. Combination of hdVAD and gRNFL yielded the best diagnostic accuracy of all parameter permutations for mild and any POAG, suggesting the potential of hdVAD to supplement gRNFL and other ocular parameters in the diagnosis of early POAG.

This is a 2021 ARVO Annual Meeting abstract.

 

 

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