June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Foveolar Avascular Zone Area Mediates the Effects of Retinal Ganglion Cells Dysfunction on Optic Nerve Rim Area in Glaucoma Suspects with Obstructive Sleep Apnea
Author Affiliations & Notes
  • Joby Tsai
    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Andrew Tirsi
    Ophthalmology, Manhattan Eye Ear and Throat Hospital, New York City, New York, United States
    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Hosam Sheha
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Danielle Kacaj
    John F Kennedy High School, Bellmore, New York, United States
  • Derek Orshan
    New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York, United States
  • Vasiliki Gliagias
    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Peter H Derr
    Diopsys, Inc, New Jersey, United States
  • Sung Chul Park
    Ophthalmology, Manhattan Eye Ear and Throat Hospital, New York City, New York, United States
    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Stephen A Obstbaum
    Ophthalmology, Manhattan Eye Ear and Throat Hospital, New York City, New York, United States
    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Celso Tello
    Ophthalmology, Manhattan Eye Ear and Throat Hospital, New York City, New York, United States
    Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Footnotes
    Commercial Relationships   Joby Tsai, None; Andrew Tirsi, Diopsys, Inc (C); Hosam Sheha, None; Danielle Kacaj, None; Derek Orshan, None; Vasiliki Gliagias, None; Peter Derr, Diopsys, Inc (E); Sung Chul Park, None; Stephen Obstbaum, None; Celso Tello, Diopsys, Inc (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3377. doi:
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      Joby Tsai, Andrew Tirsi, Hosam Sheha, Danielle Kacaj, Derek Orshan, Vasiliki Gliagias, Peter H Derr, Sung Chul Park, Stephen A Obstbaum, Celso Tello; Foveolar Avascular Zone Area Mediates the Effects of Retinal Ganglion Cells Dysfunction on Optic Nerve Rim Area in Glaucoma Suspects with Obstructive Sleep Apnea. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3377.

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

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Abstract

Purpose : Recent research suggests that normal tension glaucoma is a chronic progressive ischemic process in the optic nerve. This cross-sectional prospective study looked at the relationship among foveolar avascular zone (FAZ) area, a biomarker for retinal microvascular integrity, retinal ganglion cell (RGC) function assessed by pattern electroretinogram (PERG), and optic nerve head (ONH) rim area (RA) in glaucoma suspects (GS) with obstructive sleep apnea (OSA).

Methods : Nine consecutive GS participants (18 eyes) with normal visual fields tests and suspicious glaucomatous ONH appearance were enrolled and underwent a complete ophthalmologic examination, optical coherence tomography-angiography (OCTA), OCT, and pattern electroretinogram (PERG). FAZ area was measured using ImageJ software. Mediation Analysis Process by Andrew Hayes was tested. PERG parameters consisted of Magnitude (Mag, µv), Magnitude (MagD, µv), and MagD/Mag ratio. OCT RA was also used.

Results : Multiple linear regressions were calculated to predict RA (mm2) based on age (years) and Mag (µv). A significant regression equation was found (F(2,14)=6.234, p=0.012) with an R2 of 0.471. Predicted RA was equal to 1.245 + 0.102(Mag) – 0.006(age). RA decreased by 0.006mm2 for each year of age and decreased by 0.102 mm2 for every unit decrease in Mag. Only Mag was a significant predictor of RA (p= 0.037). An identical regression model was found to be significant in predicting RA based on age and MagD (F(2,14)=6.036, p=0.013) with an R2 of 0.463. Predicted RA was 1.275 + 0.100(MagD) – 0.006(age). RA decreased by 0.006mm2 for each year of age and decreased by 0.100mm2 for every unit decrease in MagD. Only MagD was a significant predictor of RA (p=0.042). Mediation analysis revealed that FAZ area was a significant partial mediator in the relationship between MagD and RA. Both the direct (effect=0.179, p=0.002, 95% CI [0.073, 0.286]) and indirect (effect= -0.055, 95% CI [-0.137, -0.006]) effects of MagD on RA remained significant, demonstrating that FAZ area is a partial mediator in this relationship.

Conclusions : We report PERG abnormalities in asymptomatic GS with OSA. Our data suggests early optic nerve and RA defects are mediated by chronic progressive microvascular abnormalities, possibly occurring simultaneously with vascular changes in optic nerve.

This is a 2021 ARVO Annual Meeting abstract.

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