Retinal vessel diameter in normal-tension glaucoma patients with asymmetric progression

Lee, Tae Eun; Kim, Yong Yeon; Yoo, Chungkwon

doi:10.1007/s00417-014-2756-6

Cited by 12 publications

(10 citation statements)

References 43 publications

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“…More recently, Lee et al compared 27 eyes with bilateral NTG who showed asymmetrical glaucoma progression after a mean follow-up of 24.3 months and found significant narrowing of retinal arteriolar calibre in progressed eyes but not in contralateral stable eyes. 102 No correlation was found for retinal venular calibre, however, they hypothesised this may be due to clinically asymptomatic engorgement of venous blood flow in glaucoma, together with different regulatory mechanisms governing changes in retinal artery and vein diameters. 102 No significant intereye difference was observed in the mean baseline vessel calibre between progressed and stable eyes.…”

Section: Longitudinal Relationship Between Retinal Vascular Changes Wmentioning

confidence: 99%

“… 102 No correlation was found for retinal venular calibre, however, they hypothesised this may be due to clinically asymptomatic engorgement of venous blood flow in glaucoma, together with different regulatory mechanisms governing changes in retinal artery and vein diameters. 102 No significant intereye difference was observed in the mean baseline vessel calibre between progressed and stable eyes.…”

Section: Longitudinal Relationship Between Retinal Vascular Changes Wmentioning

confidence: 99%

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Retinal vasculature in glaucoma: a review

et al. 2017

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Despite the critical impact of glaucoma on global blindness, its aetiology is not fully characterised. Elevated intraocular pressure is highly associated with glaucomatous optic neuropathy. However, visual field loss still progresses in some patients with normal or even low intraocular pressure. Vascular factors have been suggested to play a role in glaucoma development, based on numerous studies showing associations of glaucoma with blood pressure, ocular perfusion pressure, vasospasm, cardiovascular disease and ocular blood flow. As the retinal vasculature is the only part of the human circulation that readily allows non-invasive visualisation of the microcirculation, a number of quantitative retinal vascular parameters measured from retinal photographs using computer software (eg, calibre, fractal dimension, tortuosity and branching angle) are currently being explored for any association with glaucoma and its progression. Several population-based and clinical studies have reported that changes in retinal vasculature (eg, retinal arteriolar narrowing and decreased fractal dimension) are associated with optic nerve damage and glaucoma, supporting the vascular theory of glaucoma pathogenesis. This review summarises recent findings on the relationships between quantitatively measured structural retinal vascular changes with glaucoma and other markers of optic nerve head damage, including retinal nerve fibre layer thickness. Clinical implications, recent new advances in retinal vascular imaging (eg, optical coherence tomography angiography) and future research directions are also discussed.

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Section: Longitudinal Relationship Between Retinal Vascular Changes Wmentioning

confidence: 99%

Section: Longitudinal Relationship Between Retinal Vascular Changes Wmentioning

confidence: 99%

Retinal vasculature in glaucoma: a review

et al. 2017

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“…Previously, our group reported that the central retinal arteriolar equivalent (CRAE) decreased over time in the progressed eyes, whereas no significant decrease was seen in the stable eyes in patients with bilateral normal-tension glaucoma (NTG). 7 Other studies by our group showed that patients with NTG had smaller diameters of the central retinal vessels than healthy subjects, 8 and the mean CRAE was smaller in the NTG than in the high-tension glaucoma group. 9 In those studies, most patients were categorized into early stage of glaucoma (mean deviation ‡ -6 dB).…”

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confidence: 61%

Author Response: Diagnostic Ability of Retinal Arteriolar Diameter Measurements in Glaucoma

Kim

Yoo

2016

Invest. Ophthalmol. Vis. Sci.

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We thank Pekel et al. 1 for their interest in our work 2 and for the opportunity to discuss the findings of our study. They mentioned in their study that the mean retinal arteriolar caliber did not statistically differ between young relatives of patients with open-angle glaucoma (OAG) and age-matched healthy controls; however, we would like to point out that not all relatives of patients with OAG progress to glaucoma. Several studies reported that the lifetime risk of glaucoma was approximately 20% to 30% in relatives of patients with glaucoma 3,4 (i.e., approximately 70% to 80% of relatives did not suffer from glaucoma although they had a family history). We suggest that it will be meaningful to compare the baseline retinal vessel diameters (RVDs) between relatives who progressed to glaucoma over time and those who did not. In addition, the Blue Mountains Eye Study revealed that retinal arteriolar narrowing was associated with long-term risk of OAG and the authors proposed the concept that early vascular changes are involved in the pathogenesis of OAG. 5As already stated in our article, we agree with the point made by Pekel and Pekel. 6 That it is not clear whether the retinal arteriolar narrowing precedes or follows the development of glaucomatous damage. However, we suggest that the changes in retinal vascular diameter may occur even at an early stage of glaucoma development. Previously, our group reported that the central retinal arteriolar equivalent (CRAE) decreased over time in the progressed eyes, whereas no significant decrease was seen in the stable eyes in patients with bilateral normal-tension glaucoma (NTG). 7 Other studies by our group showed that patients with NTG had smaller diameters of the central retinal vessels than healthy subjects, 8 and the mean CRAE was smaller in the NTG than in the high-tension glaucoma group. 9 In those studies, most patients were categorized into early stage of glaucoma (mean deviation ‡ -6 dB).Pekel and Pekel 6 pointed out a number of drawbacks regarding our article when using RVD as a diagnostic parameter. First, they were concerned that the methods used for measuring RVD cannot assess the three-dimensional and cross-sectional morphology of the vessel. Although we can only measure RVDs in two-dimensional images, RVD is known to have a significant correlation with retinal blood flow velocity when assessed by laser Doppler velocimetry. 10 Further, RVDs could be reliably measured using computer-assisted software and both interrater and intrarater reliabilities were high. 11 The second comment was that the quality of the retinal images may affect the RVD measurements. In our study, we excluded the RVD data from the disc photographs with poor image quality. Clinicians have to give attention to image quality when interpreting disc photographs. The third concern was that many systemic and ocular disorders might influence RVD. We agree that RVD has fundamental problems when used as a solitary diagnostic marker of glaucoma. Therefore, clinicians need to use RVD as a suppleme...

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“…The FAZ in the progressed NTG group was larger than that in the control group, similar to a previous study [30], except the larger FAZ in the current study occurred before significant NTG development. Since circulation is an important factor for the occurrence and progression of NTG, rather than prominent high IOP [31, 32], more extensive vascular defects could be possible for impending NTG compared to HTG. Outer retinal perfusion was lower in the progressed HTG group than the control group, while similar choriocapillaris perfusion may be because the choroid is not the major site of glaucoma damage.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Basal Macular Circulation and Following Glaucomatous Damage in Progressed High-Tension and Normal-Tension Glaucoma

et al. 2019

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Objectives: Evaluate the correlation between basal macular circulation and late structural damage in progressed high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) via optical coherence tomography angiography (OCTA). Methods: Patients who received an OCTA examination were divided into progressed HTG, progressed NTG, and well-controlled HTG (control) groups. Superficial macular vessel density (SmVD), deep macular vessel density (DmVD), foveal avascular zone (FAZ), and flow area of the outer retina and choriocapillaris were obtained by one OCTA device. Associations between macular angiography and glaucoma parameters, including the visual field, retinal nerve fiber layer, and ganglion cell complex, were analyzed. Results: A total of 60 eyes from 60 patients were enrolled. The progressed HTG and NTG groups had lower SmVD than the control group, while the progressed NTG group had lower DmVD and a larger FAZ than the control group. The flow area of the outer retina in the progressed HTG group was lower than that of the control. A significant correlation between SmVD and glaucoma parameters was found in the progressed HTG group, while a similar correlation between SmVD and DmVD to glaucoma parameters was observed in the progressed NTG group. Conclusion: The progressed HTG and NTG patients showed an impaired vascular intake before significant disease development compared to well-controlled cases.

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Retinal vessel diameter in normal-tension glaucoma patients with asymmetric progression

Abstract: In our series of NTG patients with asymmetric progression, central retinal artery diameter decreased over time in the progressed eyes, whereas no significant decrease in the central retinal artery diameter was seen in the stable eyes.

Cited by 12 publications

References 43 publications

Retinal vasculature in glaucoma: a review

Retinal vasculature in glaucoma: a review

Author Response: Diagnostic Ability of Retinal Arteriolar Diameter Measurements in Glaucoma

Correlation between Basal Macular Circulation and Following Glaucomatous Damage in Progressed High-Tension and Normal-Tension Glaucoma

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