June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Association of Foveal Avascular Zone Change and Glaucoma Progression
Takashi Nishida; Sasan Moghimi; Evan Walker; Gopikasree Gunasegaran; Jo-Hsuan Wu; Alireza Kamalipour; Golnoush Mahmoudinezhad; Linda M Zangwill; Robert N Weinreb
Author Affiliations & Notes
  • Takashi Nishida
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Sasan Moghimi
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Evan Walker
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Gopikasree Gunasegaran
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Jo-Hsuan Wu
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Alireza Kamalipour
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Golnoush Mahmoudinezhad
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Linda M Zangwill
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Robert N Weinreb
    University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Takashi Nishida Topcon, Code C (Consultant/Contractor); Sasan Moghimi National Eye Institute, University of California Tobacco-Related Disease Research Program, Code F (Financial Support); Evan Walker None; Gopikasree Gunasegaran None; Jo-Hsuan Wu None; Alireza Kamalipour Fight for Sight, Code F (Financial Support); Golnoush Mahmoudinezhad None; Linda Zangwill Abbvie, Topcon, Code C (Consultant/Contractor), National Eye Institute, Carl Zeiss Meditec, Optovue, Heidelberg Engineering, and Topcon, Code F (Financial Support), Carl Zeiss Meditec, Code P (Patent); Robert Weinreb Abbvie, Aerie Pharmaceuticals, Allergan, Amydis, Equinox, Eyenovia, Iantrek, IOPtic, Implandata, Nicox, and Topcon, Code C (Consultant/Contractor), National Eye Institute, Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Zilia, Centervue, and Topcon, Code F (Financial Support), Toromedes, Carl Zeiss Meditec, Code P (Patent)
  • Footnotes
    Support  National Institutes of Health/National Eye Institute Grants (R01EY034148, R01EY029058, R01EY11008, R01EY19869, R01EY027510, R01EY026574, EY018926 P30EY022589); Fight for Sight foundation; University of California Tobacco Related Disease Research Program (T31IP1511), and an unrestricted grant from Research to Prevent Blindness (New York, NY).
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2570. doi:
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      Takashi Nishida, Sasan Moghimi, Evan Walker, Gopikasree Gunasegaran, Jo-Hsuan Wu, Alireza Kamalipour, Golnoush Mahmoudinezhad, Linda M Zangwill, Robert N Weinreb; Association of Foveal Avascular Zone Change and Glaucoma Progression. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2570.

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Abstract

Purpose : To investigate the association between longitudinal changes of foveal avascular zone (FAZ) area and the rate of structural and functional progression in glaucoma

Methods : A longitudinal cohort included 115 eyes (46 glaucoma suspect and 66 primary open angle glaucoma [POAG]) of 81 patients having at least 4 visits and 2 years of follow-up for OCTA/OCT and visual field (VF). A separate test-retest cohort included 4 reliable optical coherence tomography angiography (OCTA) scans from 32 eyes of 24 healthy participants and, the 5th-percentile-P values by linear regression analysis from permutation were recorded. Any eye with a P value smaller than the 5th-percentile and a positive slope of FAZ area change was categorized into the faster FAZ area change in the longitudinal cohort. Generalized linear mixed-effects models were used to investigate the association of a faster FAZ area change (at 95% specificity) with demographic and clinical characteristics.

Results : Mean values for slope were -0.2 (-0.3 to -0.1) dB/y for VF mean deviation (MD), -0.9 (-1.1 to -0.6) µm/y for ganglion cell complex (GCC), -1.3 (-1.4 to -1.1) %/y for whole image vessel density (wiVD), and 0.0059 (0.0040 to 0.0078) mm2/y for FAZ area, respectively. 34 eyes were identified as having fast FAZ enlargement; 81 eyes were not at 95% specificity of FAZ area in healthy eyes. At 95% specificity, faster GCC thinning and faster VF MD loss was associated with a faster FAZ increase (-1.3 (95%CI, -1.9 to -0.7) µm/y vs -0.7 (95%CI, -0.9 to -0.4) µm/y; P=0.018, -0.4 (-0.7 to -0.1) dB/y vs -0.2 (-0.2 to -0.1) dB/y; P=0.026, respectively), while wiVD was not (-1.2 (-1.5 to -1.0) %/y vs -1.3 (-1.5 to -1.0) %/y; P=0.929, Table 1). Standard deviation of IOP as well as IOP range was also associated with faster FAZ change in separate multivariable models (OR: 7.88 (1.26 to 49.3) per 0.5 mmHg higher, P=0.027; OR: 2.67 (1.11 to 6.40) per 1 mmHg higher; P=0.025, respectively, Table 2).

Conclusions : Faster FAZ area increase was associated with faster rates of GCC thinning and VF MD loss in glaucoma eyes. Standard deviation of IOP and IOP range were also associated with faster foveal avascular zone area change.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Copyright © 2024 Association for Research in Vision and Ophthalmology.
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