Abstract
Purpose :
To determine if comparing superficial (SCP) and deep (DCP) retinal vessel perfusion density (PD) improves diagnostic accuracy of glaucoma in high myopia (HM) eyes.
Methods :
This was a pilot study of a prospective case control study. Single eyes from subjects with HM alone (HM-N) or with glaucoma (HM-G) underwent ophthalmic examination and macular optical coherence tomography angiography scans. Scans were marked around the fovea with an annulus, excluding the foveal avascular zone. The annulus was divided into 6 sectors (i.e. superior (S), supero-nasal (SN), supero-temporal (ST), inferior (I), inferonasal (IN), inferotemporal (IT)). Images were processed to obtain PD values of SCP and DCP, adjusted for ocular magnification. Sectoral analysis was performed using SCP PD comprising large vessels, capillaries, or all vessels (full PD) and compared with SCP/DCP full PD ratios. Area Under the Receiver Operating Characteristics Curve (AUC) were estimated for HM-N vs HM-G using a probit model ROC regression after adjusting for age and gender. Wald test was used to compare AUC between groups, where p<0.05 was considered significant.
Results :
Sixty eyes from 60 subjects were included comprising 25 HM-N and 35 HM-G. The mean age of HM-N and HM-G subjects respectively were 50.6±12.8 and 56.3±13.7 years. There was no significant difference in axial length or spherical equivalent between HM-N vs HM-G (Table 1). The highest AUC for glaucoma diagnosis was observed using SCP large vessel/DCP full PD ratios in the IT sector (0.80 vs SCP large vessel PD alone 0.55, p=0.04). SCP large vessel/DCP full PD ratios also performed better in the SN sector (0.75 vs 0.55, p<0.01). SCP capillary/DCP full PD ratios performed better than SCP capillary PD alone in the SN (0.73 vs 0.44, p<0.01), I (0.73 vs 0.55, p<0.01) and IN (0.74 vs 0.54, p=0.02) sectors. SCP full/DCP full PD ratios performed better in the S (0.69 vs 0.49, p=0.03), SN (0.75 vs 0.51, p=0.03), I (0.71 vs 0.42, p<0.01) and IN (0.74 vs 0.50, p<0.01) sectors.
Conclusions :
SCP/DCP PD ratios may provide better evidence for differentiating HM-G from HM-N than using SCP PD alone; and show excellent diagnostic accuracy of glaucoma in HM eyes using large vessel SCP/DCP full PD ratios in the IT sector.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.