Macular and Optic Nerve Head Vessel Density and Progressive Retinal Nerve Fiber Layer Loss in Glaucoma

Autor: Takuhei Shoji, Rafaella C. Penteado, Huiyuan Hou, Robert N. Weinreb, Sasan Moghimi, Mark Christopher, Christopher Bowd, Adeleh Yarmohammadi, Linda M. Zangwill, Elham Ghahari, Patricia Isabel C. Manalastas, Kyle Hasenstab
Rok vydání: 2018
Předmět:
Retinal Ganglion Cells
Male
Aging
Intraocular pressure
genetic structures
Nerve fiber layer
Glaucoma
Neurodegenerative
Eye
Ophthalmology & Optometry
chemistry.chemical_compound
Nerve Fibers
0302 clinical medicine
Prospective Studies
Fluorescein Angiography
Tomography
medicine.diagnostic_test
Middle Aged
Fluorescein angiography
Ganglion
Visual field
Open-Angle
medicine.anatomical_structure
Disease Progression
Public Health and Health Services
Optic nerve
Female
Glaucoma
Open-Angle
Tomography
Optical Coherence
medicine.medical_specialty
Optic Disk
Clinical Sciences
Tonometry
Tonometry
Ocular
03 medical and health sciences
Clinical Research
Opthalmology and Optometry
Ocular
Ophthalmology
medicine
Humans
Eye Disease and Disorders of Vision
Intraocular Pressure
Aged
business.industry
Prevention
Neurosciences
Retinal Vessels
Retinal
medicine.disease
eye diseases
chemistry
Optical Coherence
030221 ophthalmology & optometry
Visual Field Tests
sense organs
Visual Fields
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Ophthalmology, vol 125, iss 11
ISSN: 0161-6420
DOI: 10.1016/j.ophtha.2018.05.006
Popis: PURPOSE:To investigate prospectively the relationship between macular and peripapillary vessel density and progressive retinal nerve fiber layer (RNFL) loss in patients with mild to moderate primary open-angle glaucoma. DESIGN:Prospective, observational study. PARTICIPANTS:One hundred thirty-two eyes of 83 patients with glaucoma followed up for at least 2 years (average: 27.3±3.36 months). METHODS:Measurements of macular whole image vessel density (m-wiVD) and optic nerve head whole image vessel density (onh-wiVD) were acquired at baseline using OCT angiography. RNFL, minimum rim width (MRW), and ganglion cell plus inner plexiform layer (GCIPL) thickness were obtained semiannually using spectral-domain OCT. Random-effects models were used to investigate the relationship between baseline vessel density parameters and rates of RNFL loss after adjusting for the following confounding factors: baseline visual field mean deviation, MRW, GCIPL thickness, central corneal thickness (CCT), and mean intraocular pressure during follow-up and disc hemorrhage, with or without including baseline RNFL. MAIN OUTCOME MEASURES:Effects of m-wiVD and onh-wiVD on rates of RNFL loss over time. RESULTS:Average baseline RNFL thickness was 79.5±14.8 μm, which declined with a mean slope of -1.07 μm/year (95% confidence interval, -1.28 to -0.85). In the univariate model, including only a predictive factor and time and their interaction, each 1% lower m-wiVD and onh-wiVD was associated with a 0.11-μm/year (P < 0.001) and 0.06-μm/year (P= 0.031) faster rate of RNFL decline, respectively. A similar relationship between low m-wiVD and onh-wiVD and faster rates of RNFL loss was found using different multivariate models. The association between vessel density measurements and rate of RNFL loss was weak (r2= 0.125 and r2= 0.033 for m-wiVD and onh-wiVD, respectively). Average CCT also was a predictor for faster RNFL decline in both the univariate (0.11μm/year; P < 0.001) and multivariate models. CONCLUSIONS:Lower baseline macular and optic nerve head (ONH) vessel density are associated with a faster rate of RNFL progression in mild to moderate glaucoma. Assessment of ONH and macular vessel density may add significant information to the evaluation of the risk of glaucoma progression and prediction of rates of disease worsening.
Databáze: OpenAIRE
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