Discriminating Between Compressive Optic Neuropathy With Glaucoma-Like Cupping and Glaucomatous Optic Neuropathy Using OCT and OCTA

Abstract

Purpose To discriminate between compressive optic neuropathy with glaucoma-like cupping (GL-CON) and glaucomatous optic neuropathy (GON) by comparing the peripapillary retinal nerve fiber layer (pRNFL) thickness and retinal microvasculature using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods In this retrospective cross-sectional study, OCT scans were performed on 28 eyes of GL-CON, 34 eyes of GON, and 41control eyes to determine the pRNFL thickness, ganglion cell complex thickness, and cup/disc ratio. OCTA scans were conducted for 12 eyes of GL-CON, 15 eyes of GON, and 15 control eyes to measure the vessel density of the peripapillary and macular areas. Analysis of covariance was used to perform the comparisons, and the area under the curve was calculated. Results The GON eyes had a significantly thinner pRNFL in the inferior quadrant and greater vertical cup/disc ratio than the GL-CON eyes. In the radial peripapillary capillary segment, the vessel density of the GON in the inferior sectors was significantly lower than in the GL-CON. The superficial macular vessel density in the whole-image, peritemporal, perinasal, and peri-inferior sectors was significantly smaller in the GON group than in the GL-CON group. The best parameter for discriminating between GL-CON and GON was the superficial macular vessel density in the peritemporal sector. Conclusions GL-CON eyes showed a characteristic pattern of pRNFL and retinal microvascular changes. Translational Relevance GL-CON can be effectively distinguished from GON by detecting the alterations in the pRNFL and retinal microvasculature using OCT and OCTA.

Topographic comparison of the retinal microvascular changes between patients with compressive and glaucomatous optic neuropathies

“…In addition, the GON group showed a greater change in the macular DCP VD; the GON group had a significant decrease in macular DCP VD in all areas compared with the NC group and in half of the areas compared with the CON group. The difference in the DCP VD between the two optic neuropathies is inconsistent with the previous study 13 . As mentioned above, Lei et al compared the microvasculature between CON with glaucoma-like cupping and GON and reported no significant difference in DCP VD between the two optic neuropathies.…”

“…Several studies have compared the structural changes between CON and GON 8 – 12 , focusing on the different topographical patterns of structural damage on the optic disc, peripapillary retinal nerve fiber layer (pRNFL), and macular ganglion cell-inner plexiform layer (mGCIPL). Lei et al recently reported the difference in microvasculature between CON and GON 13 . However, they included CON with glaucoma-like cupping, which were not representative of typical CON with optic chiasm compression.…”