Defective angles of localized retinal nerve fiber layer reflect the severity of visual field defect- a cross-sectional analysis

Chen, Alexander; Lai, Ing‐Chou; Cho, Wan-Hua; Lai, Hung-Yin; Lin, Pei‐Wen; Wu, Pei-Chang; Kuo, Ming‐Tse

doi:10.1186/s12886-020-01396-y

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…In our study we found that, GCC and RNFL were thinner in the glaucomatous eyes compared to the control subjects. This agrees with what has already been demonstrated that RNFL thickness reduction occurs in glaucoma especially measuring the angular width of localized RNFL defect is also a viable method for determining the severity of visual field defect (6,7) .…”

Section: Discussionsupporting

confidence: 91%

Changes of Macular Vessel Density in Primary Open Angle Glaucoma

Mohammed

2021

The Egyptian Journal of Hospital Medicine

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Background: Glaucoma is a known cause of irreversible blindness worldwide. Several techniques are used for its diagnosis and follow-up. Optical coherence tomography angiography (OCTA) is new technology that provides a quantitative assessment of the microcirculation of the retina and optic nerve in a rapid, noninvasive method. Objective: To evaluate the changes at the macular vessel density (MVD) in primary open glaucoma patients (POAG) to correlate these changes with the changes of both ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness. Patients and Methods: Fifty healthy participants and fifty primary open angle glaucoma (POAG) subjects underwent visual field analysis, measurement of the whole image MVD, measurement of the average (RNFL) thickness, and measurement of the average thickness of (GCC). The area under the curve (AUC) was assessed for each parameter to differentiate POAG from healthy eyes. Results: MVD was lower in POAG than in the control group. The glaucomatous group showed that MVD was 21.18 ± 2.6 at the fovea, while it was 39.5 ± 4.71 at the parafovea. There was a statistically significant positive correlation between MVD (foveal and parafoveal (especially at the superior quadrant) and the mean deviation (MD) (R+ve, P < 0.05). There was a statistically significant positive correlation between MVD and structural parameters. The ROC curves showed that the cut-off points were < 28.2 and < 48 for MVD at the fovea and parafoveal area respectively, at the superficial vascular plexus with 100% sensitivity & 100% specificity between the controls and POAG eyes. Conclusions: MVD was reduced in cases with POAG compared to the control group. The assessment of macular vessel density by OCTA gave us good diagnostic abilities for diagnosis and management of glaucoma.

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Section: Discussionsupporting

confidence: 91%

Changes of Macular Vessel Density in Primary Open Angle Glaucoma

Mohammed

2021

The Egyptian Journal of Hospital Medicine

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“…Remarkably, RNFL remained significant after controlling for disease stage. This may reflect the widening and deepening of localized RNFL defects with disease progression 85–87. Further research on the relationship between wedge defects and disease severity may provide insight into glaucoma pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

Wedge Defects on Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma: Prevalence and Associated Clinical Factors

LeTran

Burkemper

O'Fee

et al. 2022

Journal of Glaucoma

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Précis: Among subjects with glaucoma, wedge-shaped defects on optical coherence tomography angiography (OCTA) were associated with disc hemorrhages (DH), paracentral visual field (VF) defects, increased cup-to-disc ratio (CDR), and thinner retinal nerve fiber layer (RNFL).Purpose: To examine determinants of wedge defects on peripapillary OCTA in glaucoma. Materials and Methods:A total of 278 eyes of 186 subjects with mild to severe primary open-angle glaucoma underwent 6×6 spectraldomain OCTA imaging of the superficial peripapillary retina from 2016 to 2020 at an academic practice. Wedge defects were defined as focal microvasculature loss that extends outward from the optic nerve in an arcuate, wedge shape. Logistic regression models controlling for intereye correlation identified variables significantly associated with wedge defects. Eyes with profound microvasculature loss in both hemispheres were excluded. Candidate variables included: age, sex, race or ethnicity, diabetes, hypertension, follow-up duration, baseline untreated intraocular pressure, intraocular pressure at time of imaging, DH history, paracentral VF defects, CDR, central corneal thickness, spherical equivalent, VF mean deviation, RNFL thickness, and glaucoma stage.Results: Of 278 eyes, 126 (45.3%) had wedge defects in at least 1 hemisphere. In our multivariable logistic regression model, wedge defects were associated with DH history [odds ratio (

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“…Third, red-free fundus photographs in highly-pigmented Asian eyes clearly show the borders of localized RNFL defects, such as in our study 16 . Many studies in Asian eyes have therefore employed the measurement of RNFL defect width to assess glaucoma progression 17 – 21 . In addition, due to the resolution, OCT may be less sensitive than red-free fundus photographs in detecting subtle changes, especially in myopic eyes 19 , 22 – 28 .…”

Section: Discussionmentioning

confidence: 99%

Different glaucoma progression rates by age groups in young myopic glaucoma patients

Lee,

Kim

et al. 2024

Sci Rep

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We aimed to investigate the age-related glaucoma progression rates in myopic normal tension glaucoma (NTG). In this long-term retrospective cohort (7.2 ± 3.5 years), we grouped patients based on their age at initial presentation: group A (age < 30 years, 60 eyes), group B (30 ≤ age < 40, 66 eyes), and group C (40 ≤ age < 50 years, 63 eyes). We used a linear mixed-effects model to estimate retinal nerve fiber layer (RNFL) defect width enlargement rates. Group A showed a significantly faster rate of RNFL defect progression (3.01 ± 1.74°/year) than those of groups B and C (2.05 ± 1.55°/year and 2.06 ± 1.29°/year, P = 0.004 and 0.002). The difference was more marked when calculated for the first 10 years of follow-up in group A, B, and C (3.95 ± 2.70°/year, 2.39 ± 1.64°/year, and 1.98 ± 1.31°/year), and between the periods of age < 30 years, 30 ≤ age < 40 years, and 40 ≤ age < 50 years within group A. This is the first evidence of rapid glaucoma progression in the young adulthood and stabilization in older age in myopic NTG. Clinicians should consider the potentially aggressive course of glaucoma, especially in younger patients with myopic NTG, in contrast to the general slow progression in adulthood.

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Defective angles of localized retinal nerve fiber layer reflect the severity of visual field defect- a cross-sectional analysis

Cited by 4 publications

References 22 publications

Changes of Macular Vessel Density in Primary Open Angle Glaucoma

Changes of Macular Vessel Density in Primary Open Angle Glaucoma

Wedge Defects on Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma: Prevalence and Associated Clinical Factors

Different glaucoma progression rates by age groups in young myopic glaucoma patients

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