Macular vessel density versus ganglion cell complex thickness for detection of early primary open-angle glaucoma

Abstract

Background: To evaluate the macular vessel density (VD) and ganglion cell complex (GCC) thickness in preperimetric (PPG) and early perimetric primary open-angle glaucoma (PG) eyes, and to compare the diagnostic ability of the two measurements to discriminate PPG and early PG eyes from healthy eyes. Methods: Seventy-nine eyes in 72 subjects (31 normal, 26 PPG, and 22 early PG eyes) were included in the consecutive case series. Macular VD and GCC thickness were acquired simultaneously using the 6 × 6 mm 2 highdensity AngioRetina scanning mode. Diagnostic abilities were assessed using the area under the receiver operating characteristic curve (AUROC). Results: Compared to healthy eyes, whole image VD (wiVD) and GCC thickness were significantly lower in PPG and early PG eyes (all P < 0.025). The percent reduction of wiVD was lower than that of GCC thickness in early PG eyes (P < 0.05), while they were similar in PPG eyes (P > 0.05). Regionally, greater VD attenuation and GCC thinning were identified in the perifovea than in the parafovea in both groups (all P < 0.05). Moreover, the percent reduction of VD was less than that of GCC thickness in the perifoveal region in PPG eyes (P < 0.05). The AUROCs for wiVD and GCC thickness were 0.824 and 0.881, respectively, in PPG eyes (P > 0.05), and 0.918 and 0.977, respectively, in early PG eyes (P > 0.05). Conclusions: Macular VD and GCC thickness significantly decreased in PPG and early PG eyes. The perifoveal region appeared to be more vulnerable to macular VD attenuation and GCC thinning in early glaucoma. Our results showed that macular VD measurements may be helpful for detecting and understanding early glaucomatous damage.

Macular vessel density, branching complexity and foveal avascular zone size in normal tension glaucoma

“…In agreement with previous OCTA studies, we observed a significant relationship between worse MD and lower pfVD, which in this study was measured in the perifoveal superficial capillary network 9 , 12 , 32 – 37 . As expected, there was also a significant relationship between worse MD and thinner mGCC and cpRNFL (Table 2 ).…”

“…MSFD is an interesting area for study given the changes in MSFD noted in patients with conditions such as hypertension and lacunar stroke and the role of ocular blood flow in the pathogenesis of glaucoma 23,24 . www.nature.com/scientificreports/ In agreement with previous OCTA studies, we observed a significant relationship between worse MD and lower pfVD, which in this study was measured in the perifoveal superficial capillary network 9,12,[32][33][34][35][36][37] . As expected, there was also a significant relationship between worse MD and thinner mGCC and cpRNFL (Table 2).…”

The role of pattern electroretinograms and optical coherence tomography angiography in the diagnosis of normal-tension glaucoma

“…In this study, macular VD showed a glaucoma detection ability similar to that of MD in eyes with early glaucoma (AUC values for macular VD and MD: 0.730 and 0.752, respectively). Previous studies have demonstrated a range of AUC values for the ability of macular VD (0.562–0.918) in distinguishing eyes with early glaucoma from normal eyes 18 , 30 – 33 . Differences in scan size, OCTA specifications, glaucoma severity, and glaucoma type may have contributed to the different outcomes in terms of AUC values; therefore, further studies are warranted to elucidate the exact role of macular VD.…”

Optical Coherence Tomography-Angiography, a New Diagnostic and Follow-Up Tool for Glaucoma

“…This situation suggested that OCTA may be helpful in early diagnosis and follow-up of glaucoma [31]. The percentage reduction in macular vessel density in early glaucoma eyes was lower than the percentage reduction in macular ganglion cells thickness, whereas this ratio was similar in preperimetric eyes [32]. Rapid reduction in macular vessel density has been associated with severe glaucoma [33].…”